Health Care Reform Legislation

Health Care Reform Grants

State Allocations (updated May 11, 2012)Provides state-by-state allocations of health care reform funding. This document will be updated periodically to reflect the release of new grant awards.

Inventory of Funding Opportunities (updated June 9, 2011)Provides a comprehensive resource for information on health care reform funding opportunities. This document is updated periodically to include the most recent grant announcements and program guidance. The latest Information is shaded.

Health Care Updates

July 20, 2015: HHS, USDA Provide Guidance on A-87 Waiver Extension The Department of Health and Human Services (HHS) and the Department of Agriculture (USDA) released additional guidance to states on the OMB Circular A-87 cost allocation exception, which allows states to use enhanced Medicaid funding to build integrated systems without having to allocate shared costs to human services programs. In October, HHS announced a three-year extension of the waiver, through December 31, 2018. Click here for more information: http://www.medicaid.gov/federal-policy-guidance/downloads/smd072015.pdf

July 20, 2015: GAO Releases Report on Behavioral Health The Government Accountability Office (GAO) released a report that examines options for low-income adults with behavioral health conditions to receive treatment in selected states (four non-Medicaid expansion states and six Medicaid expansion states): http://www.gao.gov/products/GAO-15-449

June 25, 2015: Supreme Court Upholds Health Insurance Subsidies The U.S. Supreme Court, in a 6 to 3 decision, upheld the ability for individuals to receive subsidies for health insurance purchased on both state and federal exchanges in the King v. Burwell case: http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf

June 17, 2015: ACF Releases Program Instruction on Medicaid Eligibility for Former Foster Care Youth The Administration for Children and Families (ACF) released guidance and technical assistance to states regarding the Affordable Care Act’s mandated extension of Medicaid eligibility to age 26 for certain young adults formerly in foster care: http://www.acf.hhs.gov/programs/cb/resource/pi1505

June 2015: MACPAC Releases Report to Congress on Medicaid and CHIP The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2015 report to Congress, which examines a variety of topics, including Delivery System Reform Incentive Payment programs, access to dental care for adults, and access to health care for individuals with behavioral health conditions and children in the child welfare system: https://www.macpac.gov/publication/june-2015-report-to-congress-on-medicaid-and-chip/

May 14, 2015 HRSA Announces Family-to-Family Health Information Center Awards The Health Resources and Services Administration (HRSA) awarded $5 million in new and continuing competitive grant awards for the centers, which support families of children with special health care needs. Funding was recently extended through FY 2017 as part of the Medicare Access and CHIP Reauthorization Act of 2015. Click here for a listing of awards: http://www.hrsa.gov/about/news/pressreleases/150514familytofamily.html

May 6, 2015: CMS Proposes Changes to Requirements for Medicare Part D CMS is seeking comment on an interim final rule that would revise requirements related to beneficiary access to covered Part D drugs. Pharmacy claims and beneficiary requests for reimbursement for prescriptions written by prescribers other than physicians and eligible professionals who are permitted by state law to prescribe medications, will not be rejected or denied by the plan under the revised requirements. Click here to view the notice: http://www.gpo.gov/fdsys/pkg/FR-2015-05-06/pdf/2015-10545.pdf

May 5, 2015: HHS Announces Community Health Center Awards The Department of Health and Human Services (HHS) announced $101 million in Affordable Care Act (ACA) funding to 164 health center sites in 33 states and two territories for the delivery of comprehensive primary health care services: http://www.hhs.gov/news/press/2015pres/05/20150505a.html

April 24, 2015: HHS OIG Releases Drug Rebate Report The HHS, Office of the Inspector General (OIG) examined drug rebates for brand-name drugs in Medicaid and Medicare Part D. It found that Medicaid rebates exceeded Part D rebates by a substantial margin. Click here to view the report: http://go.usa.gov/3ZFJQ

April 14, 2015: CMS Releases Proposed Rule to Extend 90/10 Funding for Medicaid Eligibility Systems CMS issued a proposed rule that would extend access to enhanced federal financial participation for Medicaid eligibility and enrollment systems on an ongoing basis. The proposed rule would permanently extend the 90% matching rate for states to improve their Medicaid eligibility and enrollment systems and would allow states to indefinitely receive a 75% matching rate for maintaining and operating modernized systems. Click here to view the proposal: http://www.gpo.gov/fdsys/pkg/FR-2015-04-16/pdf/2015-08754.pdf

April 6, 2015: CMS Proposes Extending Mental Health Parity to Medicaid, CHIP CMS released a proposed rule to provide Medicaid and CHIP recipients with equal access to mental health and substance abuse benefits as provided by private health plans. A number of states currently set limits on mental health coverage. The proposed rule would not affect Medicaid fee-for-service plans, but it would stop such limits for Medicaid managed care plans. The rule would require states to provide mental health and substance abuse coverage and include parity provisions in Medicaid managed care contracts. The full scope of the proposed rule applies to CHIP, regardless of whether care is provided through fee-for-service or managed care. States that have expanded Medicaid under the Affordable Care Act (ACA) already are required to meet parity requirements. Click here to view the proposal: https://www.federalregister.gov/articles/2015/04/10/2015-08135/medicaid-and-childrens-health-insurance-programs-mental-health-parity-and-addiction-equity-act

April 1, 2015: CMS Releases Bulletin on TMA, QI Expiration CMS provided information to states on the April 1 expiration of the Transitional Medical Assistance (TMA) and Qualifying Individuals (QI) programs. Following the congressional recess, the Senate is expected to consider the Medicare Access and CHIP Reauthorization Act (H.R. 2), which recently passed the House and would permanently extend the programs (see FFIS Issue Brief 15-07). Click here to view the CMS bulletin: http://www.medicaid.gov/federal-policy-guidance/downloads/cib-04-01-2015.pdf

March 31, 2015: Supreme Court Issues Opinion on Medicaid Reimbursement Case The United States Supreme Court issued a ruling, in a 5-4 decision, that private health care providers cannot sue states to force them to increase their Medicaid reimbursement rates. Writing on behalf of the majority, Justice Scalia concluded that the Supremacy Clause of the U.S. Constitution does not allow a private right of action for health care providers. The case, Armstrong v. Exceptional Child Center, raised the issue of whether Medicaid providers have the right to challenge Medicaid reimbursement rates set by states. The case is based on a challenge from health care providers about the level of reimbursement rates for serving disabled adults and children in Idaho. Click here to view the ruling: http://www.ffis.org/sites/default/files/public/supreme_court_decision_march_31.pdf

March 30, 2015: GAO Releases Report on CHIP GAO released a report on the effect of CHIP on children’s coverage and access, as well as considerations for extending funding: http://www.gao.gov/products/GAO-15-348

March 20, 2015: HHS Announces Proposed Rule on Electronic Health Records (EHRs) HHS announced the release of the State 3 notice of proposed rulemaking for the Medicare and Medicaid EHRs Incentive Programs. Of note, the proposal specifies new criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicaid incentive payments. Click here for details: http://www.hhs.gov/news/press/2015pres/03/20150320a.html

March 10, 2015: CMS Updates Home and Community-Based Services Toolkit CMS updated portions of its toolkit, which provides states with information on meeting regulatory requirements for residential and nonresidential home and community-based settings: http://www.medicaid.gov/hcbs/

March 4, 2015:ASPE Releases Final Report on Health and Human Services Program Integration The Office of the Assistance Secretary for Planning and Evaluation (ASPE) commissioned the Urban Institute to develop a series of papers exploring integration efforts to date and analyzing available options under ACA. The final report provides an overview of findings and summarizes the challenges and prospects for integration in the future. Click here to view the report: http://aspe.hhs.gov/hsp/15/IntegrationFinalRpt/rpt_IntegrationFinalRpt.pdf

March 3, 2015: Supreme Court Hears Arguments in King v. Burwell The Supreme Court heard oral arguments in King v. Burwell, a case that will decide whether low- and middle-income consumers in states with federally run exchanges will continue receiving subsidies to help them buy insurance. According to observers, the Supreme Court appeared divided during oral arguments. The court’s decision is expected in June. To read a transcript of the oral arguments, click here: http://www.supremecourt.gov/oral_arguments/argument_transcripts/14-114_lkhn.pdf

March 2, 2015: GAO Releases Report on Medicaid Information Technology (IT) GAO reviewed states’ implementation of IT systems that support Medicaid, specifically those systems that support program integrity initiatives. It recommends that CMS require states to measure and report quantifiable benefits of program integrity systems when requesting federal funds. Click here to view the report: http://www.gao.gov/products/GAO-15-207

February 23, 2015:IRS Seeks Comments on Cadillac Tax Guidance The Internal Revenue Service (IRS) released initial guidance on an excise tax on high-cost employer-sponsored health plans—referred to as the “Cadillac tax”—that takes effect in 2018. The notice describes the types of plans that will be subject to the tax. The IRS is seeking comment on the guidance and expects to issue another notice before publishing a proposed rule. Click here for details: http://www.irs.gov/pub/irs-drop/n-15-16.pdf

February 19, 2015:HHS Announces FY 2015 Home Visiting Awards HHS awarded $386 million to states, territories, and nonprofit organizations to support the Maternal, Infant, and Early Childhood Home Visiting Program. The program is set to expire on April 1, 2015. Click here to view the awards: http://www.hhs.gov/news/press/2015pres/02/20150219a.html

February 10, 2015:GAO Releases Report on Medicaid Third-Party Liability Efforts GAO issued a report that examines the extent to which Medicaid enrollees have private insurance, and initiatives taken by states and CMS to improve third-party liability efforts. GAO recommends that CMS routinely monitor and share information across states regarding efforts and challenges, as well as provide guidance on state oversight efforts. Click here to view the report: http://www.gao.gov/products/GAO-15-208

January 29, 2015: CMS Releases Bulletin on 2015 Federal Poverty Level Standards CMS released guidance on the new poverty standards, which are used to determine eligibility for Medicaid, CHIP, and advance payments of the premium tax credit and cost-sharing reductions for the purchase of health coverage through the exchange: http://www.medicaid.gov/federal-policy-guidance/downloads/cib-01-29-2015.pdf

January 23, 2015: CMS Innovation Center Releases Multi-Payer Primary Care Evaluation Report The Innovation Center released its first evaluation report, which highlights features of the state initiatives that are positively associated with improved outcomes: http://innovation.cms.gov/Files/reports/MAPCP-EvalRpt1.pdf

January 20, 2015: Supreme Court Hears Oral Arguments on Medicaid Reimbursement Case The United States Supreme Court heard oral arguments in Armstrong v. Exceptional Child Center, a case that raises the issue of whether Medicaid providers have the right to challenge Medicaid reimbursement rates set by states. The case is based on a challenge from health care providers about the level of reimbursement rates for serving disabled adults and children in Idaho. The court is likely to issue an opinion on this case close to the end of its current term, in June 2015.

January 16, 2015: CDC Publishes Healthcare-Associated Infections Progress Report The Centers for Disease Control and Prevention (CDC) published a National and State Healthcare-Associated Infections Progress Report, detailing progress in eliminating healthcare-associated infections. http://www.cdc.gov/hai/progress-report/index.html

January 14, 2015: Federal Judge Strikes Down Provision in DOL’s Home Health Care Rule U.S. District Court Judge Richard Leon issued an opinion in the case Home Care Association of America v. Weil that vacates the Department of Labor’s (DOL’s) Home Care Final Rule revised definition of companionship services. DOL’s rule would have extended minimum wage and overtime pay regulations to most home-health workers. Judge Leon noted that Congress’s intent to exempt minimum and overtime wage requirements for home health workers is still the intent today and that a change would require an act of Congress. Previously, on December 22, 2014, Judge Leon issued an opinion that vacated the third party regulation amended by the Home Care Final Rule. DOL has filed an appeal. Click here for DOL’s statement: http://www.dol.gov/whd/homecare/litigation.htm

January 9, 2015: MACPAC Publishes Data Book on Dual Eligibles The Medicaid and CHIP Payment and Access Commission (MACPAC) released its data book, which provides information on the demographic and other personal characteristics, expenditures, and health care utilization of individuals who are dually eligible for Medicare and Medicaid coverage: http://www.macpac.gov/publications/Duals_DataBook_2015-01.pdf?attredirects=0

December 17, 2014: HRSA Seeks Comment on MIECHV Final Report The Health Resouces and Services Administration (HRSA) published a new information collection for a final report that must be submitted by Maternal, Infant and Early Childhood Home Visiting Program (MIECHV) competitive grant recipients: http://www.gpo.gov/fdsys/pkg/FR-2014-12-17/pdf/2014-29520.pdf

December 16, 2014: HHS Announces State Innovation Models Awards The Department of Health and Human Services (HHS) awarded more than $665 million to 28 states, the District of Columbia, and three territories to design and test health care payment and service delivery models that improve health care quality, accessibility, and affordability: http://www.hhs.gov/news/press/2014pres/12/20141216a.html

December 15, 2015 HHS OIG Releases Report on Medicaid Rebates The Department of Health and Human Services (HHS) Office of Inspector General OIG issued a report on states’ collection of offset and supplemental Medicaid rebates based on its survey of states in February 2013: http://oig.hhs.gov/oei/reports/oei-03-12-00520.asp

December 12, 2014: HRSA Releases Guidance on 340B Drug Pricing Program HRSA issued policy to clarify the use of the 340B Medicaid exclusion file to ensure that manufacturers do not pay a Medicaid rebate in addition to providing a 340B discount: http://www.hrsa.gov/opa/updates/december2014.html

December 12, 2014: GAO Releases Report on Medicaid Eligibility IT System Changes The Government Accountability Office (GAO) published a report examining federal funding for Medicaid eligibility systems, states’ use of the funding, state implementation challenges, and CMS’s oversight of the funding: http://www.gao.gov/products/GAO-15-169

December 9, 2014: HHS OIG Releases Report on Medicaid Managed Care A recent HHS OIG report raises doubts about the ability of private health plans, states, and CMS to ensure that individuals enrolled in Medicaid managed care have sufficient access to providers. Based on the findings, the OIG recommends that CMS work with states to improve the oversight of managed care plans. Click here to view the report: http://go.usa.gov/6he4

November 26, 2014: IRS Releases Final Regulations on Minimum Essential Coverage The Internal Revenue Service (IRS) issued final regulations on the requirement to maintain minimum essential coverage as well as rules governing certain types of exemptions from that requirement: http://www.gpo.gov/fdsys/pkg/FR-2014-11-26/pdf/2014-27998.pdf.

November 19, 2014: HHS Releases Two Reports on Quality of Care HHS released its fifth annual report on the quality of care of children in Medicaid and the Children’s Health Insurance Program (CHIP), as well as its first report on the quality of health care for adults enrolled in Medicaid. Both reports examine the work of states to measure and report on quality measures, and quality improvement efforts in managed care. Click here to access the reports: http://www.medicaid.gov/

October 28, 2014: CMS to Propose Permanent 90/10 Funding and A-87 Waiver Extension CMS announced its intent to propose regulations that would permanently extend the availability of 90% federal matching funds for Medicaid eligibility and enrollment systems. CMS will also provide a three-year extension of the OMB Circular A-87 cost allocation waiver authority for integrated health and human service program eligibility system development. Click here for more details: http://www.ffis.org/sites/ffis.org/files/public/Letter_to_APHSA_and_NAMD_from_Cindy_Mann_10-28-14.pdf

October 23, 2014: CMS Seeks Comment on Basic Health Program Funding Methodology CMS released the proposed methodology and data sources necessary to determine federal payment amounts made in program year 2016 to states that establish a Basic Health Program under the Affordable Care Act (ACA): http://www.gpo.gov/fdsys/pkg/FR-2014-10-23/pdf/2014-25257.pdf

October 23, 2014: HHS Announces Transforming Clinical Practice Initiative The Department of Health and Human Services (HHS) will invest $840 million over four years to support networks that help doctors access information and improve health outcomes, such as peer-based learning networks and networks aimed at supporting workforce development: http://www.hhs.gov/news/press/2014pres/10/20141023a.html

October 9, 2014: HHS Publishes Home Health Proposed Rule HHS published a proposed rule in the Federal Register to revise the current conditions of participation that home health agencies must meet to participate in Medicare and Medicaid. The changes would focus on care delivered to patients, allow greater flexibility to meet quality standards, and eliminate unnecessary procedural requirements. Click here for additional details: http://www.gpo.gov/fdsys/pkg/FR-2014-10-09/pdf/2014-23895.pdf

October 7, 2014: DOL Delays Enforcement of Home Care Rule The Department of Labor (DOL) announced it will temporarily suspend enforcement of a final rule providing overtime and minimum wage protections to home care workers. For the first six months after the rule takes effect on January 1, 2015, DOL will not bring enforcement actions against any state or employer that fails to comply with new requirements imposed by the rule. During the subsequent six months, beginning June 1, 2015, DOL will exercise its discretion in determining whether to bring enforcement actions, giving strong consideration to the extent to which states and other employers have made good faith efforts to bring their home care programs into compliance. Click here for more details: http://social.dol.gov/blog/an-announcement-concerning-the-home-care-final-rule/

October 6, 2014: GAO Releases Report on Inmates Enrolled in Medicaid The Government Accountability Office (GAO) provided information to Congress on enrollment and Medicaid costs for inmates: http://www.gao.gov/products/GAO-14-752R

September 30, 2014: HRSA Seeks Comment on MIECHV Final Report HRSA is requesting comments on its final report for competitive grants under the Maternal, Infant and Early Childhood Home Visiting Program (MIECHV), which will be used to assess the program’s effectiveness and its impact on the health and development of recipients: http://www.gpo.gov/fdsys/pkg/FR-2014-09-30/pdf/2014-23175.pdf

September 30, 2014: Judge Rules Against Health Law Subsidies in Federal Exchange A federal district judge in Oklahoma ruled (State of Oklahoma v. Burwell) against a federal regulation that permits tax credits for health insurance purchased on the federal exchange operating in 36 states. The key question before the court focused on a statutory interpretation of whether Congress intended for federal subsidies to flow only through health exchanges established by states. Last month, the U.S. Court of Appeals for the District of Columbia said it would rehear a case (Halbig v. Burwell) in which a three-judge panel ruled that subsidies can only be made available in states that establish their own exchange. Oral arguments are scheduled for December. In July, the federal Fourth Circuit Court (King v. Burwell) ruled unanimously in favor of the federal government, holding that subsidies can be made available to qualifying consumers in all states. That decision has been appealed to the Supreme Court but has not been set for conference.

September 29, 2014: GAO Releases Report on Disabled Dual-Eligible Beneficiaries GAO conducted a study of the integration of Medicare and Medicaid benefits for disabled dual-eligible beneficiaries and found that integration could lead to improved care but may not reduce Medicare spending: http://www.gao.gov/products/GAO-14-523

September 29, 2014: GAO Releases Report on Issuer Participation in Marketplace GAO examined the number and types of health insurance issuers participating in both the individual and small-business health insurance marketplaces beginning in 2014: http://www.gao.gov/products/GAO-14-657

September 29, 2014: HHS OIG Releases Report on Medicaid Managed Care The HHS Office of Inspector General (OIG) released a report that describes the standards that states establish for access to care in their Medicaid managed-care programs as well as how states determine compliance with the standards: http://go.usa.gov/vqz3

September 18, 2014: ACL Releases FLSA Home Care Rule Toolkit The Administration for Community Living (ACL) provided technical-assistance resources to help states and others comply with the Department of Labor (DOL) Fair Labor Standards Act (FLSA) home care final rule that will take effect January 1, 2015: http://www.acl.gov/NewsRoom/NewsInfo/2014/2014_09_18.aspx

September 16, 2014: CMS Outlines Process for Amending Alternative Benefit Plans CMS provided information to states on timeframes and requirements for amending Medicaid Alternative Benefit Plans, expectations for public and tribal notification, and the system to use for state plan amendment submissions: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-09-16-2014.pdf

September 8, 2014: HHS Announces Navigator Grants HHS awarded $60 million in navigator grants to 90 organizations in states with federally-facilitated and state partnership exchanges to help consumers access health coverage: http://www.hhs.gov/news/press/2014pres/09/20140908a.html

September 8, 2014: GAO Releases Report on Arkansas’s Medicaid Expansion Waiver GAO examined HHS’s approval process for the Arkansas waiver, and found that HHS did not ensure the demonstration will be budget-neutral. HHS disagreed with the findings. Moreover, GAO expressed its long-standing concerns with HHS’s policy, process, and criteria for reviewing and approving Medicaid section 1115 demonstrations. Click here to access the report: http://www.gao.gov/products/GAO-14-689R

September 4, 2014: Appeals Court to Revisit Ruling on ACA Subsidies The U.S. Court of Appeals for the District of Columbia (D.C.) agreed to rehear a case that questioned whether the federal government can provide subsidies to consumers in 36 states who obtain health insurance on HealthCare.gov. In July, the D.C. Circuit (Halbig v. Burwell) struck down a lower court decision and held that subsidies are only available in states that establish their own health insurance exchange. Hours later, the federal Fourth Circuit Court (King v. Burwell) unanimously upheld an Internal Revenue Service regulation making subsidies available to qualifying middle- and low-income consumers regardless of whether they are purchasing insurance through a state-run or federally-run exchange. The D.C. Circuit vacated the July ruling in Halbig v. Burwell and set oral arguments for December 17.

September 3, 2014: HRSA Announces Supplemental Awards to Delta States HRSA announced supplemental awards to current grantees of the Delta States Rural Development Network Grant Program (Delta States). The additional funds will allow grantees to implement outreach and enrollment activities for the next ACA health insurance open enrollment period. Click here for a list of awards: http://www.gpo.gov/fdsys/pkg/FR-2014-09-03/pdf/2014-20845.pdf

September 3, 2014: CMS Releases National Health Expenditures Projections The CMS Office of the Actuary released a report on the outlook for national health expenditures from 2013 through 2023. Based on preliminary figures, total Medicaid expenditures are projected to have increased by 6.7% in 2013 due to several factors including temporary increases to primary care physician payment rates mandated by ACA as well as states’ increasing provider reimbursement rates and expanding benefits. Medicaid spending is projected to grow by 12.8% in 2014. Click here to access the report: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-09-03.html

September 2, 2014: CMS Finalizes Federal Exchange Auto-Enrollment Process CMS finalized a process to help streamline re-enrollment through the federally-facilitated exchange. People who obtained insurance through the federally-facilitated exchange will receive notices from the exchange shortly before open enrollment begins on November 15 explaining the auto-enrollment process and other options. The final rule is available here: http://www.gpo.gov/fdsys/pkg/FR-2014-07-01/pdf/2014-15362.pdf

August 29, 2014: ASPE Posts Reports on Medicaid and Human Services Integration The HHS Assistant Secretary for Planning and Evaluation (ASPE) released three reports on varying aspects of integration, including opportunities under ACA to modernize human services eligibility systems, examples of practices for coordinating eligibility, and using behavioral economics to inform integration: http://aspe.hhs.gov/office_specific/hsp.cfm

August 2014: HHS Releases CHIP Evaluation HHS issued a comprehensive evaluation of the Children’s Health Insurance Program (CHIP). The report provides state-level detail and covers a variety of topics, including enrollment trends, characteristics of enrollees, and implications of health reform. Click here to access the report: http://aspe.hhs.gov/health/reports/2014/CHIPevaluation/rpt_CHIPevaluation.pdf

August 29, 2014: CMS Releases Medicaid Eligibility and Enrollment Template CMS seeks comment on the Implementation Advanced Planning Document (IAPD) template, which will be used to assess state requests for enhanced federal funding related to Medicaid eligibility determination systems: http://www.gpo.gov/fdsys/pkg/FR-2014-08-29/pdf/2014-20590.pdf

August 27, 2014: HRSA Announces Awards for Small Health Care Provide Quality Improvement Program HRSA announced it will award supplemental grants to current grantees to provide services during the September 15, 2014 to July 31, 2015 funding period: http://www.gpo.gov/fdsys/pkg/FR-2014-08-27/pdf/2014-20389.pdf

August 26, 2014: HHS Announces Funding for Medical Homes HHS announced $35.7 million in funding to health centers in 44 states, the District of Columbia, and Puerto Rico to support patient-centered medical homes through new construction and facility renovations: http://www.hhs.gov/news/press/2014pres/08/20140826a.html

August 19, 2014: HHS OIG Releases Report on Medicaid Drug Rebate Dispute Resolution The HHS Office of Inspector General (OIG) released a report examining disputes between states and drug manufacturers on the amount of money that manufacturers owe in rebates. It recommends that the Centers for Medicare & Medicaid Services (CMS) work with states to improve and standardize claims data as well as play a stronger role in dispute resolution. Click here to access the report: http://oig.hhs.gov/oei/reports/oei-05-11-00580.asp

August 5, 2014: ACF Announces FY 2013 PREP Awards The Administration for Children and Families (ACF) announced Personal Responsibility Education Program (PREP) competitive grant awards for FY 2013. PREP is funded by the Affordable Care Act (ACA), and is currently set to expire at the end of FY 2015. Click here for a list of recipients: http://www.acf.hhs.gov/programs/fysb/resource/2013-cprep-awards

August 4, 2014: HHS Announces FY 2014 Home Visiting Program Awards HHS announced $106.7 million in formula grant awards to 46 states, the District of Columbia, and five jurisdictions as part of the Maternal, Infant, and Early Childhood Home Visiting Program established by ACA. The program is currently set to expire on April 1, 2015. Click here for more information and a list of grantees: http://www.hhs.gov/news/press/2014pres/08/20140804a.html

August 1, 2014: CMS Extends Temporary Moratoria on Enrollment of New Ambulance Suppliers and HHAs CMS extended the moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specified locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey because of a high risk of fraud, waste, or abuse: http://www.gpo.gov/fdsys/pkg/FR-2014-08-01/pdf/2014-18174.pdf

July 31, 2014: HHS Announces ACA Mental Health Services Awards HHS announced $54.6 million in ACA funding to support health centers in 47 states and Puerto Rico to establish or expand behavioral health services. Click here for details, including awards by state: http://www.hhs.gov/news/press/2014pres/07/20140731a.html

July 29, 2014: GAO Releases Report on Medicaid Financing A recent Government Accountability Office (GAO) report finds that states have increasingly relied on funds from providers and local governments in recent years to finance the nonfederal share of Medicaid. GAO recommends that CMS take steps to ensure states report accurate and complete data on all sources of funds. Click here for the report: http://www.gao.gov/products/GAO-14-627

July 25, 2014: CMS Compiles Quarterly Listing of Program Issuances The notice from CMS includes manual instructions, substantive and interpretive regulations, and other Federal Register notices published from April through June 2014. The quarterly listings are here: http://www.gpo.gov/fdsys/pkg/FR-2014-07-25/pdf/2014-17488.pdf

July 17, 2014: CMS Provides Clarifications to Territories on ACA CMS sent the following letters to clarify the applicability of certain Affordable Care Act (ACA) provisions to health insurance issuers in the territories:

July 14, 2014: HHS Unveils Medicaid Innovation Accelerator Program HHS announced it is investing $100 million to help accelerate state innovation in Medicaid with a focus on: identifying and advancing new models of care; data analytics; improved quality measurement; and state-to-state learning, rapid-cycle improvement, and evaluation. Click here for more details on this new program: http://www.hhs.gov/news/press/2014pres/07/20140714a.html

July 9, 2014: HHS Announces Health Care Innovation Awards HHS announced the remaining prospective recipients for round two of the Health Care Innovation Awards, bringing the total to $360 million across 27 states and the District of Columbia: http://www.hhs.gov/news/press/2014pres/07/20140709b.html

July 7, 2014: HHS Awards ACA Funding to Train New Primary Care Providers HHS announced $83.4 million in ACA funding to support primary care residency programs in 60 teaching health centers. For more details, including a list of awards, click here: http://www.hhs.gov/news/press/2014pres/07/20140707b.html

July 3, 2014: CMS Outlines Medicaid Payment Options for Implementation of Home Health Rule CMS released guidance to help states understand Medicaid reimbursement options for costs resulting from a Department of Labor (DOL) regulation extending federal minimum wage and overtime pay to direct care works: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-03-2014.pdf

July 1, 2014: HHS OIG Report Finds Exchanges Faced Challenges Resolving Data Inconsistencies The HHS Office of Inspector General (OIG) released a report that examines how federal and state health insurance exchanges ensured the accuracy of information submitted by applicants. It found that during the review period (October-December 2013), federal exchanges were unable to resolve most data inconsistencies because the system was not fully operational. The abilities of state exchanges to resolve inconsistencies varied. The full report is here: https://oig.hhs.gov/oei/reports/oei-01-14-00180.asp

June 30, 2014: GAO Releases Report Comparing Prescription Drug Prices Across Federal Programs The Government Accountability Office (GAO) issued a report comparing retail reimbursement prices paid by the Department of Defense, Medicaid, and Medicare Part D for a sample of prescription drugs. GAO found that Medicaid paid the lowest average net prices. Click here for the report: http://www.gao.gov/products/GAO-14-578

June 26, 2014: HHS Proposes Auto-Enrollment for Exchange Plans HHS issued a proposed rule that would allow most people participating in federal and state-based health insurance exchanges to be enrolled automatically for a second year of coverage. Under the proposed rule, consumers would be auto-enrolled in their current health plans as long as their incomes and covered family members have not changed and their health plan is being offered in 2015. Consumers may continue to receive the same level of federal subsidies if they gave permission for their tax records to be checked automatically when they first applied for coverage. State-based exchanges would be able to adopt this model or propose an alternate approach. Click here for details: http://www.hhs.gov/news/press/2014pres/06/20140626a.html

June 25, 2014: HHS OIG Issues Report on Medicaid Drug Rebates A recent report examined how states report the federal share of Medicaid drug rebates. It found that states rely on different methodologies, and the CMS has not issued national guidance. Click here to view the report: http://oig.hhs.gov/oas/reports/region6/61300001.asp

June 23, 2014: GAO Releases Report on Medicaid and Nursing Home Coverage GAO issued the following report that reviews the financial characteristics of Medicaid nursing home applicants and methods to reduce assets to qualify for coverage: http://www.gao.gov/products/GAO-14-473

June 20, 2014: CMS Proposes New Preventive Services State Survey CMS seeks comments on a new survey to gain a better understanding of state efforts to increase the utilization of preventive services in Medicaid and the Children’s Health Insurance Program (CHIP): http://www.gpo.gov/fdsys/pkg/FR-2014-06-20/pdf/2014-14482.pdf

June 19, 2014:DOL Releases Additional Guidance on Home Health Care Rule The Department of Labor (DOL) released additional guidance to help states and others determine how consumer-directed Medicaid programs may be affected by a final rule extending federal minimum wage and overtime pay to direct care workers, such as home health aides and personal care attendants: http://www.dol.gov/whd/homecare/joint_employment.htm

June 13, 2014: MACAP Releases Report to Congress The Medicaid and CHIP Payment and Access Commission (MACPAC) is required to submit two reports to Congress each year. The June 2014 report focuses on the future of the Children’s Health Insurance Program (CHIP), Medicaid’s role in financing long-term services and supports, strategies to improve the overall health of Medicaid enrollees, and effective program administration: http://www.macpac.gov/reports/2014-06-13_MACPAC_Report.pdf?attredirects=0

June 11, 2014: HRSA Releases Guidance on Health Center Oversight The Health Resources and Services Administration (HRSA) issued the following letter to provide clarification and updated information on the review and oversight of Health Center Program requirements: http://bphc.hrsa.gov/policiesregulations/policies/pal201408.html

June 3, 2014: CMS Delays Finalized Prescription Drug FULs CMS announced it is delaying the finalization of the ACA Federal Upper Limits (FULs) for prescription drugs, which were expected to be finalized in July. At this time, it is unclear when CMS intends to issue guidance.

May 29, 2014: HHS OIG Releases Report on Home Health Background Checks HHS Office of Inspector General (OIG) issued the following report reviewing state policies for background checks of home health agency employees: http://oig.hhs.gov/oei/reports/oei-07-14-00131.asp

June 2014: HRSA Releases Guidance on Ryan White and Advance Premium Tax Credits The Health Resources and Services Administration (HRSA) released policy guidance regarding the use of Ryan White HIV/AIDS funds to purchase health insurance for clients in the exchange and the reconciliation of advance premium tax credits: http://hab.hrsa.gov/affordablecareact/1404policyclarificatioin.pdf

May 30, 2014: CDC Awards $19.5 Million to Prevention Research Centers The Centers for Disease Control and Prevention (CDC) awarded funds to 26 academic institutions in 25 states to study how people and their communities can avoid or counter the risks for chronic illnesses: http://www.cdc.gov/media/releases/2014/p0530-research-centers.html

June 3, 2014: HHS Announces $300 Million for Community Health Centers HHS announced Affordable Care Act (ACA) funds to help community health centers expand service hours, hire more medical providers, and add additional services: http://www.hhs.gov/news/press/2014pres/06/20140603a.html

May 30, 2014: CMS Releases Guidance on Post-Windsor Policy for Non-MAGI Populations CMS issued guidance to states regarding the application of the Windsor decision to populations such as the elderly and people with disabilities whose eligibility for Medicaid is not determined on the basis of modified adjusted gross income (MAGI): http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-14-005.pdf

May 23, 2014: CMS Extends Electronic Health Record Incentive Program Deadlines CMS released a proposed regulation that would give certain providers additional time to meet stage 2 of meaningful use in the Electronic Health Record (HER) Incentive Program. It would also change the definition of certified electronic health record technology and change the requirements for the reporting of clinical quality measures for 2014. Click here for additional details: http://www.gpo.gov/fdsys/pkg/FR-2014-05-23/pdf/2014-11944.pdf

May 22, 2014: CMS Announces New Funding for State Health Care Innovation CMS released a funding opportunity announcement for a second round of State Innovation Models (SIM) grants. This initiative provides support to states to test innovative payment and delivery models that improve health and lower spending for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). CMS will award approximately $30 million for up to 15 Model Design cooperative agreements and $700 million for up to 12 state-sponsored Model Test cooperative agreements. Click here for more details, including application deadlines: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-05-22.html

May 16, 2014: CMS Releases Final 2015 Health Insurance Exchange Rule CMS issued the final rule for health insurance exchange and insurance market standards in 2015 and beyond. The rule finalizes a number of policies, including standards for navigators and other counselors who help people sign up for coverage and additional changes to the Small Business Health Options Program (SHOP). Click on the links below for additional information.

May 9, 2014: HRSA Releases Memo on 340B Drug-Pricing Program Audits The Health Resources and Services Administration (HRSA) released its findings from FY 2012 audits of 340B covered entities, which include inability to maintain accurate database information, billing contrary to the Medicaid Exclusion File (which may have resulted in duplicate discounts), and dispensing drugs to ineligible individuals: http://www.hrsa.gov/opa/updates/140509auditresults.html

May 9, 2014: CMS Releases Fiscal Accountability Guidance CMS issued the following guidance to states regarding fiscal accountability in administering Medicaid. It covers federal statutes and regulations on the use of provider-related donations to fund the nonfederal share of Medicaid payments. Click here for more details: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-14-004.pdf

May 2, 2014: HHS Announces New Health Law Exemptions HHS broadened the number of people who can purchase health coverage this year before the next open enrollment period. The department will provide special enrollment periods for people who have or are eligible to receive temporary employer-sponsored coverage after leaving a job, people whose individual plans will come up for renewal outside the regular open enrollment period and those in AmeriCorps national service programs. HHS is also extending temporary hardship exemptions to people who signed up for qualifying coverage outside an exchange before May 1, 2014, and certain individuals engaged in service through an AmeriCorps program. Click here to view the guidance: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf

April 30, 2014: MACPAC Releases Details on Medicaid Inpatient Hospital Payment Policies The Medicaid and CHIP Payment and Access Commission (MACPAC) released a spreadsheet that documents each state’s fee-for-service inpatient hospital payment policy, including how states set their payment rates and details on adjustments/supplemental payments: http://www.macpac.gov/publications

April 11, 2014: CMS Issues Q&A on Risk Corridors CMS issued a question-and-answer (Q&A) document on the budget-neutrality regulations for risk corridors. CMS noted that although it anticipates that risk corridors collections will be sufficient to pay for all risk corridors payments, if those collections are insufficient to make the payments for a year, all payments for that year will be reduced pro rata to the extent of any shortfall. To read the full document, click here: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf

April 9, 2014: MACPAC Issues Report on Medicaid Expansion in Three States The Medicaid and CHIP Payment and Access Commission (MACPAC) issued a report on the implementation of ACA and Medicaid enrollment expansion in three states—Maryland, California, and Nevada. The report can be viewed here: http://tinyurl.com/ltvs9qc

April 9, 2014: MACPAC Releases Financial Alignment Tables MACPAC released a series of tables on the financial alignment initiative for individuals who are dually eligible for Medicaid and Medicare in participating states. The tables can be accessed here: http://tinyurl.com/k4xw8hb

April 9, 2014: MACPAC Posts Final Report on Medicaid Payment Models MACPAC posted a final report on advanced payment models for Medicaid in four states (Arkansas, Minnesota, Oregon, and Pennsylvania). To read the findings in the full report, click here: http://tinyurl.com/lp6em4x

March 27, 2014: CDC Releases Report on State Medicaid Coverage for Smoking Cessation The Centers for Disease Control and Prevention (CDC) issued a report that reviews the coverage of cessation treatments by state Medicaid programs. The report finds that only a few states provide comprehensive coverage. More details are available at: http://www.cdc.gov/media/releases/2014/p0327-smoking-coverage.html

March 26, 2014: Administration Extends Open Enrollment Deadline in Special Cases The administration announced that the open enrollment period to purchase health care coverage on the federal exchange, which ended March 31, 2014, will be extended under certain circumstances. The guidance below provides additional details.

March 25, 2015: CMS Seeks Comment on Community First Choice Option Evaluation CMS is proposing a new information-collection activity to evaluate the implementation and progress of the Community First Choice Option. The results will be included in a report to Congress and is designed to evaluate the effectiveness of the program as well as increase understanding of state spending on long-term services and supports. Click here for more details: http://www.gpo.gov/fdsys/pkg/FR-2014-03-25/pdf/2014-06518.pdf

March 14, 2014: MACPAC Releases Report to Congress The Medicaid and CHIP Payment and Access Commission (MACPAC) released its March 2014 Report to the Congress, which focuses on the interaction among Medicaid, the Children’s Health Insurance Program (CHIP), and exchange coverage as well as program integrity issues and the future of CHIP:http://www.macpac.gov/reports

March 14, 2014: HHS Announces Another Extension of High-Risk Insurance Pools HHS announced that individuals currently enrolled in the federally run Pre-Existing Condition Insurance Plan (PCIP), who have not yet found new health insurance coverage through the exchange, can purchase an additional month of PCIP coverage through April 30, 2014. More information can be found at: http://www.pciplan.com/

March 12, 2014: HRSA Seeks Comments on Ryan White HIV/AIDS The Health Resources Services Administration (HRSA) is seeking comments on a study to assess the current status of Ryan White services during the early and later stages of the Affordable Care Act (ACA) implementation: http://www.gpo.gov/fdsys/pkg/FR-2014-03-12/pdf/2014-05376.pdf

March 7, 2014: CMS Releases Final Rule on Basic Health Program (BHP) CMS published the final rule for the BHP and the final funding methodology that will be used to calculate the federal payment rates for states in program year 2015. Under ACA, states may establish a BHP to provide health insurance to individuals with incomes between 133%-200% of the federal poverty level. Click here for more information: http://www.medicaid.gov/Basic-Health-Program/Behavioral-Health-Program.html

March 5, 2014: HHS Releases Guidance for Key Health Law Policies: HHS announced new rules affecting implementation of the ACA, including a two-year extension of a transition policy allowing consumers to keep non-ACA compliant individual and small group market plans. Under the rule, state insurance regulators will determine whether to allow health insurers to continue offering such plans through 2016. Additionally, HHS finalized a proposal that would give states more time to transition to state-based exchanges by pushing back the deadline for approved blueprints to June 15, 2014. HHS also finalized the annual open enrollment period for plan year 2015 (November 15, 2014 through February 15, 2015) and confirmed that the current open enrollment period will end as scheduled at the end of March. More details can be found at: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-03-05-2.html

February 28, 2014: CMS Publishes FY 2014 DSH Allotments CMS announced the preliminary Disproportionate Share Hospital (DSH) state allotments for FY 2014. The allotments reflect the repeal of ACA DSH reductions for FY 2014 included in P.L. 113-67. The full notice is available at: http://www.gpo.gov/fdsys/pkg/FR-2014-02-28/pdf/2014-04032.pdf

February 21, 2014: CMS Provides Additional Guidance on Modified Adjusted Gross Income (MAGI)CMS released the following letter to states to provide guidance on how certain rules apply to individuals who are eligible for Medicaid under MAGI and receive coverage for long-term services and supports: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-14-001.pdf

February 21, 2014: CMS Updates Frequently Asked Questions (FAQs) on Health Insurance Marketplaces CMS released two new FAQs related to cost-sharing reductions for contract health services and Medicaid managed care contractors outreach to former enrollers. Click on the links below to view the FAQs:

February 21, 2014: ONC Issues Criteria for Electronic Health Record (EHR) Certification The National Coordinator for Health Information Technology (ONC) released the 2015 edition of EHR technology certification criteria. The proposed rule will be published in the Federal Register on February 26, 2014, and comments will be accepted through April 28, 2014. More details can be found here: http://www.hhs.gov/news/press/2014pres/02/20140221a.html

February 7, 2014: CMS Releases 2014 Federal Poverty Guidelines CMS released a bulletin regarding the updated poverty guidelines set by the HHS. By law, these guidelines are applied to eligibility criterion for programs including Medicaid and the Children’s Health Insurance Program (CHIP). The guidelines are also used for the advance payments of the premium tax credit and cost-sharing reductions for the purchase of health coverage through the federal and state health insurance exchanges. More information can be found here: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-02-07-2014.pdf

February 10, 2014: Treasury and IRS Issue Final Regulations on Employer Responsibility Provisions The Department of the Treasury and the Internal Revenue Service (IRS) released the final rule that implements the employer shared responsibility provisions of the Affordable Care Act (ACA). The rule addresses a number of questions about how plans can comply with the employer shared responsibility provisions, ensures that volunteers such as firefighters and emergency responders do not count as full-time employees, and phases in provisions for businesses with 50 to 99 full-time employees and those that offer coverage to most but not yet all of their full-time workers. Click here for more information: http://www.treasury.gov/press-center/press-releases/Documents/Fact%20Sheet%20021014.pdf

January 31, 2014: CMS Announces Initiative to Improve Health Outcomes in Sparsely Populated Areas CMS announced a request for application for the Frontier Community Health Integration Project, which will develop and test new models of health care in sparsely population rural counties. Eligibility is targeted to critical access hospitals in Alaska, Montana, Nevada, North Dakota, and Wyoming. More details can be found here: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2014-Press-releases-items/2014-01-31.html

January 31, 2014: MACPAC Releases New Reports The Medicaid and CHIP Payment and Access Commission (MACPAC) released two new reports. The first one provides a comparison of state Financial Alignment Initiative demonstration programs and the second provides an overview of state Medicaid fee-for-service payment policies. The reports are available at: http://www.macpac.gov/publications

January 31, 2014: CMS Requests Comment on New State-Based Marketplace Annual Reporting Tool CMS is seeking comment on a new information collection that will assist the agency in determining if states are in compliance with the reporting requirements included in ACA: http://www.gpo.gov/fdsys/pkg/FR-2014-01-31/pdf/2014-02061.pdf

January 29, 2014: CMS Seeks Comment on Evaluation of Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration CMS released details on a proposed provider survey to help identify which particular medical home care processes are associated with the largest gains in health care quality and reductions in health care cost trends: http://www.gpo.gov/fdsys/pkg/FR-2014-01-29/pdf/2014-01775.pdf

January 22, 2014: CCIIO Awards New Exchange Grants The Center for Consumer Information & Insurance Oversight (CCIIO) updated it lists of health insurance exchange establishment grants to include the release of $201.3 million to nine states (Arkansas, Delaware, Mississippi, Nevada, New Hampshire, New Mexico, Rhode Island, Utah, and Washington): http://www.cms.gov/CCIIO/Resources/Marketplace-Grants/index.html

January 17, 2014: CMS Proposes New Information Collection for Community First Choice Option CMS is requesting new data from states on the Community Choice Option. The results will be included in a report to Congress and will assist in understanding state implementation plans, the program’s effectiveness, and state spending on long-term services and supports. The notice is available at: http://www.gpo.gov/fdsys/pkg/FR-2014-01-17/pdf/2014-00916.pdf

January 13, 2014: HHS Announces Another Extension of High-Risk Insurance Pools HHS announced that individuals currently enrolled in a federally administered Pre-Existing Condition Insurance Plan (PCIP) can keep their coverage through March 31, 2014. In addition, states that run their own PCIP programs have the option of continuing coverage through the end of March. Previously, this program was extended through January 31, 2014. More information on the PCIP program is available at: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/pcip-enrollment.html

January 13, 2014: HHS Issues Latest Exchange Enrollment Numbers HHS released the third in a series of issue briefs on enrollment in the health insurance exchanges, which for the first time includes demographic information such as the age and gender of enrollees. From October 1, 2013-December 28, 2013, HHS reports that nearly 2.2 million people selected a plan on the state and federally run exchanges. Almost a quarter of those enrollees were between the ages of 18 and 34. Nearly 1.8 million people enrolled during the month of December, representing a roughly fivefold increase over the number of sign-ups in October and November combined. To view the issue brief and state-by-state enrollment data, click here: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf

January 10, 2014: CMS Releases Final Rule on Home and Community-Based Services CMS issued a final rule making several changes to the Medicaid home and community-based services (HCBS) waiver program required by the ACA. The final rule establishes new requirements for HCBS settings, gives states flexibility to combine coverage for multiple target populations into one waiver, and allows them to use a five-year renewal cycle to align certain concurrent waivers and state plan amendments. CMS says it will issue additional guidance and provide assistance to states as they begin implementing the final rule. The agency has developed a dedicated website to house information on the rule and will be hosting a series of informational webinars in the coming weeks. The website, which includes information the final rule, can be found here: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html

January 3, 2014: CMS Enhances Files for Medicaid, CHIP EnrollmentCMS issued the following bulletin outlining enhancements to the account transfer flat files that states can use to enroll individuals who have applied through the federally facilitated marketplace into Medicaid and the Children’s Health Insurance program (CHIP): http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-01-03-14.pdf

January 3, 2014: HRSA Proposes New Ryan White HIV/AIDS Study The Health Resources and Services Administration (HRSA) is proposing a new study on emerging issues related to ACA to assess the status of Ryan White HIV/AIDS program services during various stages of ACA implementation as well as to collect information on implementation challenges: http://www.gpo.gov/fdsys/pkg/FR-2014-01-03/pdf/2013-31473.pdf

December 24, 2013: HHS, DOL, Treasury Issue Proposed Rule on Employee Assistance Programs and Excepted Benefits The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Treasury Department jointly issued a proposed rule to treat certain employee assistance programs (EAPs) as excepted benefits under ACA. Under the rule, EAPs would be considered excepted if the program is free to employees and does not provide significant benefits in the nature of medical care or treatment. Details can be found here: http://www.gpo.gov/fdsys/pkg/FR-2013-12-24/pdf/2013-30553.pdf

December 23, 2013: CMS Seeks Emergency Clearance for Basic Health Program CMS is seeking emergency approval for a new information-collection item for states operating state-based exchanges to obtain premium information for the Basic Health Program: http://www.gpo.gov/fdsys/pkg/FR-2013-12-23/pdf/2013-30434.pdf

December 18, 2013: MACPAC Releases Two New Publications The Medicaid and CHIP Payment and Access Commission(MACPAC) released a data book on beneficiaries dually eligible for Medicare and Medicaid and a reference guide to federal Medicaid statute and regulations. To access the publications, click here: http://www.macpac.gov/publications

December 12, 2013: HHS Announces One-Month Extension of High-Risk Insurance Pools HHS announced that individuals currently enrolled in the federal Pre-Existing Condition Insurance Plan (PCIP) operating in 39 states can extend their coverage through January 31, 2014, if they have not yet signed up for another health insurance plan. For more information on this change and other steps being taken by HHS during the transition period, click here: http://www.hhs.gov/news/press/2013pres/12/20131212a.html

December 6, 2013: HHS Issues Guidance on Refugee Medical Assistance under ACA HHS sent two letters to state refugee coordinators on refugee medical assistance policies and the Affordable Care Act (ACA). The first letter outlines the process for waiving financial eligibility standards for Refugee Medical Assistance in order to use the modified adjusted gross income (MAGI) methodology required under Medicaid and the Children’s Health Insurance Program (CHIP). The second letter provides guidance on the expansion of Medicaid eligibility under ACA and compliance with Office of Refugee Resettlement (ORR) regulations. The letters can be accessed through the links below.

December 2, 2013: CMS Issues Home Health Final Rule CMS issued a final rule to update the Home Health Prospective Payment Rates. The rule also discusses reporting requirements, and Medicaid cost-sharing requirements related to surveys of nursing homes. Click here to view the rule: http://www.gpo.gov/fdsys/pkg/FR-2013-12-02/pdf/2013-28457.pdf

December 2, 2013: CMS Announces Provider Enrollment Application Fee CMS published the following notice in the Federal Register announcing the calendar year (CY) 2014 fee for providers enrolling in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP): http://www.gpo.gov/fdsys/pkg/FR-2013-12-02/pdf/2013-28733.pdf

November 29, 2013: IRS Releases Final Regulations for ACA Insurance Fee The Internal Revenue Service (IRS) issued a final rule implementing the Affordable Care Act (ACA) health insurance premium fee, which applies to most commercial plans including Medicaid managed care and CHIP at-risk plans. The final rule affirms that the fee will total $8 billion in CY 2014 and gradually increase to $14.3 billion by CY 2018. Because states are required to pay Medicaid health plans actuarially sound rates, the cost of the annual insurer fee on Medicaid plans will be passed on to states. To access the notice, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-11-29/pdf/2013-28412.pdf.

November 29, 2013: CMS Releases Guidance on Medicaid, CHIP Enrollment Option CMS released a guidance letter to states on a transitional option for enrolling individuals in Medicaid and CHIP. To facilitate timely enrollment in these programs in 2014, CMS will permit states to use account transfer flat files transmitted by CMS to states with federally run exchanges. These flat files do not contain the full electronic account for the individual, but provide sufficient information to identify the individual and indicate Medicaid or CHIP eligibility. This interim option is intended to ensure enrollment can be completed in a timely manner without regard to temporary file transfer system issues at the federal or state level. The guidance is available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-008.pdf

November 27, 2013: Administration Delays Online Enrollment for Small Businesses The administration announced that online applications for the Small Business Health Options Program (SHOP) will be delayed until November 2014. The one-year delay in online enrollment only affects small businesses in states where the federal government is running the SHOP exchange. In these states, small businesses still have the option to sign up for coverage through an agent, broker, or insurer that offers certified SHOP plans. Starting in 2014, only small businesses that enroll through SHOP will be eligible for tax credits to help cover the cost of coverage. Click here for more information: http://www.hhs.gov/healthcare/facts/blog/2013/11/direct-new-path-to-shop-marketplace.html

November 22, 2013: Administration Postpones Deadline for January Coverage The administration announced that consumers will have an extra week to sign up for health insurance through the exchanges. Individuals and families seeking coverage must now enroll by December 23, 2013, in order to begin receiving benefits and services at the start of the new year. The original deadline for enrollment was December 15, 2013. Consumers who meet the new deadline must submit a premium payment by December 31, 2013. The administration also announced last week that it will delay the start of open enrollment for the health insurance exchanges next fall. For the 2015 plan year, the open enrollment period will shift from October 15-December 7, 2014 to November 15-January 15, 2015.

November 22, 2013: CMS Issues New Guidance on Delivery and Payment Reforms CMS issued its fourth in a series of letters on designing and implementing integrated care models within Medicaid and the Children’s Health Insurance Program (CHIP), focusing on a framework for quality improvement and measurement: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-007.pdf

November 15, 2013: CMS Proposes New Information-Collection Activities CMS is seeking comments on new information collections related to the evaluation of the Rural Community Hospital Demonstration program as well as a new state-based marketplace annual report designed to ensure compliance with the Affordable Care Act (ACA) reporting requirements. CMS is also revising Medicare enrollment applications. More details on these changes can be found at: http://www.gpo.gov/fdsys/pkg/FR-2013-11-15/pdf/2013-27305.pdf

November 14, 2013: Administration Announces Fix to Allow Individuals to Keep Health Plans The administration announced an administrative fix to allow insurers to continue offering plans through the end of calendar year 2014 that were previously scheduled to be canceled because they did not meet the minimum coverage requirements established by ACA. Under the change, insurance companies and state insurance commissioners would be permitted, but not required, to continue these plans for current enrollees. HHS set the following letter to state insurance commissioners detailing this change: http://www.cms.gov/CCIIO/Resources/Letters/Downloads/commissioner-letter-11-14-2013.PDF

November 13, 2013: ASPE Releases Data from First Enrollment Period for Health Insurance Exchanges The Office of the Assistant Secretary for Planning and Evaluation (ASPE) released the results from the first enrollment reporting period that covers October 1- November 2, 2013 for state-based and federally run health insurance exchanges. It also provides an overview of the methodology used in compiling the data and includes information about strategies to reach consumers. Click here for more information, including state-by-state data: http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf

November 12, 2013: HHS OIG Issues Report on Medicaid Managed Care Credentialing Process The Department of Health and Human Services' (HHS) Office of Inspector General (OIG) conducted a study of state and federal oversight of the Medicaid managed care credentialing process. While state credentialing policies met federal standards, the report found that five of six states reviewed did not monitor compliance with the federal provider nondiscrimination contract provision. As such, the OIG recommends that CMS issue guidance to states on monitoring compliance. The full report can be accessed at: http://oig.hhs.gov/oei/reports/oei-09-10-00270.asp

November 7, 2013: HHS Announces $150 Million in Grants to Community Health Centers HHS announced $150 million in new awards under the Affordable Care Act (ACA, P.L. 111-148) to 236 community health centers in 43 states, the District of Columbia, Puerto Rico, and American Samoa. To read the full announcement, click here: http://www.hhs.gov/news/press/2013pres/11/20131107a.html

October 24, 2013: HHS Finalizes Additional ACA Regulations for Exchanges HHS released a rule finalizing a number of policies related to implementation of the Affordable Care Act (ACA), including provisions regarding health insurance exchanges. These policies largely are unchanged from previous proposed rules and guidance documents. For more information, go to: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/pi-final-10-24-2013.html

October 23, 2013: CMS Announces Additional Health Insurance Exchange Grants CMS announced $188 million in exchange establishments grants in Arkansas, Connecticut, the District of Columbia, Idaho, Iowa, Rhode Island, and Minnesota. Click here for all awards to date: http://www.cms.gov/CCIIO/Resources/Marketplace-Grants/index.html

October 23, 2013: Administration Announces Delay in Health Insurance Penalty The administration announced that individuals will not face tax penalties if they sign up for health insurance coverage under ACA before March 31, 2014, the end of the current open enrollment period. Previously, the administration had said that individuals would need to sign up by February 15, 2014, to avoid penalties. The administration is expected release guidance clarifying the policy change.

October 22, 2013: CMS Releases New Resource on Medicaid Managed Care Services CMS announced the availability of a new resource on Medicaid managed long long-term services and supports (MLTSS) to support states and other partners in enhancing the quality of these services. Click here for more information: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-10-22-2013.pdf

October 16, 2013: CMS Seeks Comment on New Information Collection Related to ACA Exchanges CMS issued a notice in the Federal Register requesting comments on new health insurance exchange data-collection and reporting requirements, which are necessary to determine eligibility and issue certificates of exemption as well as to ensure program integrity. More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2013-10-16/pdf/2013-24476.pdf

October 9, 2013: House Committee Chairman Requests GAO Study on Medicaid Costs for Inmates The House Energy and Commerce Committee chairmen sent a letter to the Government Accountability Office (GAO) requesting a review of projected Medicaid costs associated with jail inmates due to the ACA Medicaid expansion. Specifically, the letter requests that GAO conduct a comprehensive analysis of 1) federal Medicaid costs and enrollment data for inmates and/or detainees (for costs associated with allowable inpatient treatment) and 2) federal Medicaid costs and enrollment data for inmates who have been released into the community and are newly eligible for Medicaid due to the expansion. The letter can be accessed at: http://energycommerce.house.gov/letter/letter-gao-regarding-jail-inmates-qualification-under-health-care-laws-medicaid-expansion

October 2, 2013: MACPAC Releases New Medicaid ReportThe Medicaid and CHIP Payment and Access Commission (MACPAC) released a new report that describes the major types of data used to compute the number and percentage of Medicaid births, and compares counts and percentages using different datasets and methodologies. States rely on this data for a variety of purposes, including projecting costs and resource needs. The full report can be accessed at: https://docs.google.com/viewer?a=v&pid=sites&srcid=bWFjcGFjLmdvdnxtYWNwYWN8Z3g6NzBkYTg4ZjBlNjcxN2JmMw

September 18, 2013: CMS Finalizes Methodology for DSH Reductions CMS published a final rule in the Federal Register that outlines the methodology for implementing the FY 2014 and FY 2015 reductions to state Medicaid Disproportionate Share Hospital (DSH) allotments included in the Affordable Care Act (ACA). With the exception of minor technical changes, the final rule is identical to the proposed rule. Click here to access the notice: http://www.ofr.gov/OFRUpload/OFRData/2013-22686_PI.pdf

September 23, 2013: ACF Requests Data on PREP Grants The Administration for Children and Families (ACF) is requesting data from states on the Personal Responsibility Education Program (PREP) created under the Affordable Care Act (ACA) to educate adolescents on abstinence and contraception to prevent pregnancy and sexually transmitted diseases. The data are being collected as part of the program’s semiannual performance report. To view the request, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-09-23/pdf/2013-22995.pdf

September 23, 2013: HHS Accepts Applications for State Abstinence Education Program HHS is now accepting applications and plans from states and territories for grants under the State Abstinence Program. Further details on the program and the application can be found here: http://www.gpo.gov/fdsys/pkg/FR-2013-09-23/pdf/2013-22996.pdf

September 23, 2013: HHS Announces Conference Call on Launch of Health Insurance Marketplaces HHS announced that it will hold a conference call with state and local officials on Wednesday, September 25, at 2:30 EDT to discuss the launch of the new Health Insurance Marketplace on October 1, 2013. RSVPs can be emailed to at www.att-rsvp.com with conference ID # 303712 to receive the call-in information.

September 23, 2013: CMS Announces $67 Million in Rate Review Grants CMS announced $67 million in rate review grants to 21 states to fight rate increases and enhance health care pricing transparency. More information on the rate review grants can be accessed here: http://www.cms.gov/CCIIO/Resources/Rate-Review-Grants/index.html

September 20, 2013: HHS Announces $2.5 Million for ACA Education in Rural Areas HHS announced $2.5 million in grants to rural health organizations to help individuals better understand the benefits available, eligibility requirements, and other options in their state health insurance marketplaces as designated under ACA. The full announcement can be found here: http://www.hhs.gov/news/press/2013pres/09/20130920a.html

September 20, 2013: CMS Issues Proposed Rule for Basic Health Program CMS issued a proposed rule establishing standards for the Basic Health Program. The program provides states the option to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace. To view the proposed rule, click here: http://www.ofr.gov/OFRUpload/OFRData/2013-23292_PI.pdf

September 18, 2013: HHS Announces Coordinated Effort to Prevent Fraud in Exchanges HHS announced a new coordinated initiative with the attorney general and Federal Trade Commission (FTC) to prevent and protect against consumer fraud and privacy violations in the health Insurance marketplace. To read more about the specific steps the agencies are taking, click here: http://www.hhs.gov/news/press/2013pres/09/20130918a.html

September 13, 2013: CMS Releases Final Rule on DSH Allotment Reductions CMS released a final rule on the aggregate reductions to state Medicaid disproportionate share hospital (DSH) allotments for FY 2014-2020 as required under ACA. The final rule is similar to the proposed rule released by the department in May. To read the full announcement click here: http://www.ofr.gov/OFRUpload/OFRData/2013-22686_PI.pdf

September 13, 2013: HHS Awards $67 Million for Health Care Delivery Sites HHS announced $67 million in grants to health centers to increase access to preventative and primary health care through the Health Center New Access Point grants. To read more about the new grants, click here: http://www.hhs.gov/news/press/2013pres/09/20130913a.html

September 12, 2013: HHS Releases Report on Rate Review Savings under ACA HHS released a report which found that the “rate review” provision contained in ACA saved 6.8 million consumers an estimated $1.2 billion in health insurance premiums in 2012. Forty-six states, the District of Columbia, and five territories were awarded Health Insurance Rate Review Grants to enhance their rate review programs. The full report can be accessed here: http://www.hhs.gov/news/press/2013pres/09/20130912a.html

September 6, 2013: HHS Announces MIECHV CompetitiveAwards HHS awarded $69.7 million in grants, funded by the Affordable Care Act (ACA), to 13 states to expand Maternal, Infant, and Early Childhood Visiting (MIECHV) program activities. More details, including a list of awards by state, can be found at: http://www.hhs.gov/news/press/2013pres/09/20130906a.html

August 27, 2013: IRS Releases Final Rule on Minimum Essential Coverage The Internal Revenue Service (IRS) finalized regulations surrounding minimum essential coverage requirements. The rule specifies that Medicaid qualifies as minimum essential coverage, but certain populations that receive limited coverage under Medicaid are excluded. The final rule can be accessed at: http://www.ofr.gov/OFRUpload/OFRData/2013-21157_PI.pdf

August 30, 2013: CMS Releases Guidance on Medicaid Shared Savings Programs CMS issued a letter to states to provide guidance on reimbursement methodologies that may be used in the context of Medicaid Integrated Care Models to promote quality care and reduce costs. Click here to access the guidance: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-13-005.pdf

August 29, 2013: HHS OIG Issues Report on Medicaid Drug Pricing HHS Office of Inspector General (OIG) conducted a study of state drug pricing in State Maximum Allowable Cost (MAC) programs. The report recommends additional work to identify cost savings for Medicaid drugs. Click here for the full report: http://oig.hhs.gov/oei/reports/oei-03-11-00640.asp

August 28, 2013: CMS Releases Final Rule on Health Insurance CMS published a rule to finalize a number of policies related to the implementation of ACA, including provisions regarding health insurance exchanges or marketplaces. In general, the policies are unchanged from previous rules and guidance documents. However, the rule will allow more states to operate a State-based Small Business Health Options Program (SHOP). Click here for a link to the document as well as a summary of the key policies: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/pi-final-8-28-2013.html

August 16, 2013: CMS Provides Opportunity to Comment on Information-Collection ActivitiesCMS published several proposed information-collection items in the Federal Register related to a variety of topics, such as quality control, error rates, state plan submissions, waivers, and Affordable Care Act (ACA) requirements. Click on the following links for more details:

August 15, 2013: CMS Issues Guidance on Medicaid Eligibility ReviewsCMS released a letter to states on its interim approach for assessing payment error for eligibility in light of Affordable Care Act (ACA). CMS will implement a pilot program in place of the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs, beginning January 1, 2014. The guidance can be accessed here: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-005.pdf

August 15, 2013: HHS Announces Navigator GrantsHHS announced $67 million in grant awards to 105 Navigator grant applications in federally facilitated and state partnership marketplaces. These grantees will provide in-person assistance to help consumers navigate the health insurance marketplace. Click here for more information and a list of awardees: http://www.hhs.gov/news/press/2013pres/08/20130815a.html

August 9, 2013: CMS Issues Guidance on Medicaid Eligibility CMS released a frequently-asked-question document on a range of issues including telephone applications, Medicaid and Children’s Health Insurance Program (CHIP) eligibility policy, and the federal matching rate for eligibility systems. Other issues addressed include income excluded from the modified adjusted gross income calculations, eligibility renewals, and the transition from CHIP to Medicaid. Click here to access the document: http://www.medicaid.gov/federal-policy-guidance/downloads/faq-08-09-2013.pdf

August 1, 2013: HRSA Awards Funds for Information Technology in Health CentersThe Health Resources and Services Administration (HRSA) awarded $3 million in ACA funds to six health center network to support the implementation and adoption of health IT. For more details, including a list of grantees by state, see: http://www.hrsa.gov/about/news/pressreleases/130801hccn.html

June 25, 2013: GAO Conducted Study on Medicaid Demonstration Waivers The Government Accountability Office (GAO) examined 10 new Medicaid demonstration waivers and recommends that CMS take action to improve the budget neutrality process. The full report is available at: http://www.gao.gov/products/GAO-13-384

July 12, 2013: CMS Releases Navigator Final Rule CMS released a final rule that outlines the standards for navigators, the in-person assisters in federally facilitated and state partnership marketplaces. State-based marketplaces have the option of using this guidance or developing their own. The final rule can be accessed at: http://www.ofr.gov/OFRUpload/OFRData/2013-17125_PI.pdf

July 10, 2013: HHS Announces Outreach and Enrollment Grants HHS announced $150 million in health center grants to hire outreach and eligibility assistance workers to assist in enrolling individuals in health coverage provided by ACA. More information, including a list of grantees by state, is available at: http://www.hhs.gov/news/press/2013pres/07/20130710a.html

July 5, 2013: CMS Issues Informational Bulletin on Eligibility and Enrollment SupplementCMS updated its Medicaid Information Technology Architecture (MITA) framework to reflect eligibility and enrollment business processes and capability matrices. States have 30 days to comment on the draft update. More details are available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-05-2013-MITA.pdf

July 5, 2013: CMS Releases Final Rule on Medicaid, CHIP, and Health Insurance CMS issued a final rule implementing provisions of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) related to eligibility, enrollment, and benefits in Medicaid, CHIP, and the Health Insurance Marketplace. The final rule addresses eligibility notices and appeals processes, provides additional flexibility regarding benefits and cost sharing for state Medicaid programs, codifies several eligibility and enrollment provisions included in ACA and the Children’s Health Insurance Program Reauthorization Act (CHIPRA), and provides operational guidance to help states implement their Health Insurance Marketplaces. A copy of the final rule can be found here: http://www.ofr.gov/(X(1)S(1vpecb3pcilomwwvusd4jf2b))/OFRUpload/OFRData/2013-16271_PI.pdfJuly 2, 2013: IRS Issues Proposed Regulations on ACA Insurance Exchanges The Internal Revenue Service (IRS) issued a set of proposed regulations related to requirements for ACA insurance exchanges to report information relating to the health insurance premium tax credit enacted under ACA. The proposed regulations can be found here: http://www.gpo.gov/fdsys/pkg/FR-2013-07-02/pdf/2013-15943.pdf

July 2, 2013: HHS Awards $32 Million in Medicaid and CHIP Outreach and Enrollment Grants HHS announced round three awards under the Connecting Kids to Coverage Outreach and Enrollment program. Forty-one grantees received funds, with awards targeted to states with the largest number of children who are eligible for Medicaid and the Children’s Health Insurance Program (CHIP) but are not enrolled. More details, including a list of grantees, are available at: http://www.insurekidsnow.gov/professionals/index.html

June 20, 2013: HHS Releases Report on Medical Loss Ratio HHS released a report on the health insurer data required under the Medical Loss Ratio provisions included in the Affordable Care Act (ACA). The report finds that consumers saved $3.9 billion on premiums in 2012. Click here for the report: http://www.hhs.gov/news/press/2013pres/06/20130620a.html

June 19, 2013: GAO Releases Reports on Health Insurance Exchanges GAO released a report on the status of CMS’s efforts to establish federally facilitated health insurance exchanges. It also released a report on the status of federal and state efforts to establish exchanges for small businesses. The reports can be accessed here: http://www.gao.gov/browse/topic/Health_Care

June 6, 2013: CBO Releases Report on Dual-Eligible Beneficiaries The Congressional Budget Office (CBO) released a study on the characteristics and costs of dual-eligible beneficiaries. It also examines the different payment systems that Medicare and Medicaid use to fund care for the dual-eligibles and recent efforts to integrate those payment systems. The full report is available at: http://www.cbo.gov/publication/44308

June 14, 2013: MACPAC Releases Report to Congress on Medicaid and CHIPThe Medicaid and CHIP Payment and Access Commission (MACPAC) released its June report to Congress. The report examines Medicaid and Children’s Health Insurance Program (CHIP) eligibility and coverage for maternity services, the newly implemented increase in physician payment for primary care services, access to care for nonelderly persons with disabilities, and ways to improve the effectiveness of program integrity activities. The full report can be accessed at: http://www.macpac.gov/reports

June 14, 2013: HHS Releases Program Integrity Proposed RuleHHS released a Notice of Proposed Rulemaking (NPRM) that proposes a number of policies related to implementation of the Health Insurance Marketplaces. Much of the proposal focuses on program integrity guidelines for Health Insurance Marketplaces and premium stabilization programs. More details can be found here: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/pi-nprm-6-14-2013.html

June 6, 2013: GAO Releases Study of Health Insurance Exchanges in Selected States GAO released the following study of health insurance exchanges in seven states that reviews actions in those states in creating their exchanges. All states reviewed expect that they will be ready for enrollment by the October 1, 2103, deadline. The full report is available at: http://www.gao.gov/products/GAO-13-486 June 3, 2013: HHS OIG Releases Report on Part D Plans HHS's Office of Inspector General (OIG) released a report that fulfills its annual reporting mandate from the Affordable Care Act (ACA), which requires it to study the extent to which Part D plans include drugs commonly used by dual eligibles. The report finds that inclusion rates are high, with some variation. The full report is available here: http://oig.hhs.gov/oei/reports/oei-05-13-00090.asp

May 30, 2013: GAO Releases Report on Early Retiree Reinsurance (ERRP) and Pre-existing Condition Insurance Plan (PCIP) GAO released a report on the two temporary programs included in the Affordable Care Act (ACA). The report, which provides updated information on enrollment and spending, can be accessed at: http://www.gao.gov/assets/660/654260.pdf May 29, 2013: Federal Departments Issue Final Rule on Wellness Programs The departments of HHS, Labor, and Treasury issued a final rule on employment-based wellness programs, which is effective January 1, 2014. The rule increases the maximum permissible reward under a health-contingent wellness program and provides additional clarifications regarding the design of health-contingent wellness programs and the reasonable alternatives they must offer in order to avoid discrimination. More details are available at: http://www.hhs.gov/news/press/2013pres/05/20130529a.html

May 23, 2014: CMS Publishes Final Rule on Medical Loss Ratios CMS issued a final rule implementing the new medical loss ratio (MLR) requirements for Medicare Part C and Part D required under the Patient Protection and Affordable Care Act (P.L. 111-148). A copy of the final rule can be found here: http://www.gpo.gov/fdsys/pkg/FR-2013-05-23/pdf/2013-12156.pdf

May 15, 2013: HHS Announces Round Two Health Care Innovation Awards HHS released a funding-opportunity announcement for round two of the Health Care Innovation Awards. HHS will award up to $1 billion for projects that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and CHIP enrollees. For this second round, HHS is specifically seeking innovations in four areas: rapidly reducing costs for patients with Medicare and Medicaid in outpatient hospital and other settings; improving care for populations with specialized needs; testing improved financial and clinical models for specific types of providers, including specialists; and linking clinical care delivery to preventive and population health. More details can be found at: http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.html

May 13, 2013: CMS Releases Proposed Rule for DSH Reductions The Affordable Care Act (ACA) required aggregate reductions to state Medicaid disproportionate share hospital (DSH) allotments beginning in FY 2014. CMS issued a proposed rule, with request for comment, on the methodology for the reductions. The proposed rule recommends a methodology for FYs 2014-2015 only. More details, including illustrative reductions by state for FY 2014, are available at: http://www.medicaid.gov/federal-policy-guidance/downloads/CIB-05-13-2013.pdf

May 10, 2013: CMS Issues FAQs on Small Business Health Options Program (SHOP) CMS issued new guidance to states in the form on frequently asked questions (FAQs) on SHOP-Only marketplaces: http://cciio.cms.gov/resources/regulations/Files/shop-marketplace-5-10-2013.pdf May 9, 2013: HRSA Announces Outreach and Enrollment Assistance for Health Centers The Health Resources and Services Administration (HRSA) announced that $150 million is available to health centers to conduct outreach and education activities for the new health insurance marketplaces created by ACA. Grant applications are due May 31, and HRSA is expected to make the award decisions in July. Click here for more information: http://bphc.hrsa.gov/outreachandenrollment/

Eligible health centers and estimated award by state can be found at: http://www.hrsa.gov/about/news/2013tables/outreachandenrollment/ May 7, 2013: SAMHSA and CMS Issue Joint Guidance on Benefit Design for Children with Mental Health Conditions To help states comply with requirements under the Americans with Disabilities Act (ADA) and Medicaid’s Early Periodic Screening, Diagnostic and Treatment (EPSDT) requirements, the Substance Abuse and Mental Health Services Administration (SAMHSA) and CMS issued new guidance on designing benefit packages that will meet the needs of children, youth, and young adults with significant mental health conditions: http://www.medicaid.gov/federal-policy-guidance/downloads/CIB-05-07-2013.pdfMay 6, 2013: ACF Proposes New Collection Activity for Health Profession Opportunity Grants (HPOG)The Administration for Children and Families (ACF) is proposing two data collection efforts for evaluation of the program, which was authorized and funded under the Affordable Care Act (ACA). For more information, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-05-06/pdf/2013-10577.pdf May 1, 2013:

April 30, 2013: IRS Issues Guidance on Employer-Sponsored Coverage The Department of the Treasury’s Internal Revenue Service (IRS) issued a proposed rule on the minimum required value of employer-sponsored coverage that won’t trigger the employer mandate penalty and other provisions involving the premium tax credits on the exchanges: http://ofr.gov/OFRUpload/OFRData/2013-10463_PI.pdf

March 29, 2013: CMS Releases Final FMAP Rule CMS released the final rule, with request for comments, that provides guidance on how states should apply the Affordable Care Act’s (ACA) increased Federal Medical Assistance Percentage (FMAP) for certain Medicaid beneficiaries. In contrast to the proposed rule, the final rule announces that CMS will require states to use the threshold methodology when calculating the FMAP for the newly eligible enrollees. The final rule also describes the calculation of the FMAP for the “expansion states.” Click here to view the rule: http://www.gpo.gov/fdsys/pkg/FR-2013-04-02/pdf/2013-07599.pdf

March 27, 2013: CMCS Issues Information about Mental Health and Substance Use Screening The Center for Medicaid and CHIP Services (CMCS) issued the following bulletin to inform states about resources available to meet the needs of children under Early and Periodic Screening, Diagnostic and Treatment (EPSDT), specifically with respect to mental health and substance use disorder services: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-03-27-2013.pdf

March 20, 2013: ACL Seeks Comment on New Information Collection for Chronic Disease Program The Administration for Community Living (ACL) is proposing a new data collection for monitoring program operation and outcomes under the Empowering Older Adults and Adults with Disabilities through Chronic Disease Self-Management Education Program, funded through the Prevention and Public Health Fund. More details, including concerns raised from grantees in the initial announcement, can be found at: http://www.gpo.gov/fdsys/pkg/FR-2013-03-20/pdf/2013-06390.pdf

March 19, 2013: CMS Releases Final Rule on Long-Term Care (LTC) Facilities CMS released a final rule that revises the requirements that a LTC facility must meet to qualify to participate as a skilled nursing facility in the Medicare program or a nursing facility in the Medicaid program. The final rule makes technical changes to the interim rule that was published on February 18, 2011. The rule can be accessed at: http://www.gpo.gov/fdsys/pkg/FR-2013-03-19/pdf/2013-06276.pdfMarch 15, 2013: MACPAC Sends March Report to Congress The Medicaid and CHIP Payment and Access Commission (MACPAC) issued its fifth report to Congress. This report examines eligibility issues among Medicaid, the Children’s Health Insurance Program (CHIP), and coverage through health insurance exchanges. It also continues the commission’s work on individuals dually eligible for Medicare and Medicaid. The full report is available at: http://www.macpac.gov/reports

HOUSING AND URBAN DEVELOPMENTMarch 15, 2013: HUD Releases Model Programs to Help Communities Receive CDBG-DR Funding The Department of Housing and Urban Development (HUD) released several model programs to help communities get the remaining $11.6 billion Community Development Block Grant Disaster Recovery (CDBG-DR) funds faster. The models are broken down into three categories: housing rehabilitation, housing counseling, and housing buyouts. More information can be found here: http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/2013/HUDNo.13-036March 11, 2013: CMS Issues Proposed Rule on SHOPs CMS issued a proposed rule that would implement provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-148) related to the Small Business Health Options Program (SHOP). Specifically, the proposed rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and would implement a transitional policy regarding employees’ choice of qualified health plans in SHOP. More details on the proposed rule can be accessed here: http://www.gpo.gov/fdsys/pkg/FR-2013-03-11/pdf/2013-04952.pdf

March 11, 2013: CMS Issues Final Rule on Several Health Care Reform Measures CMS issued a final rule on the parameters related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for federally facilitated exchanges; advance payments of the premium tax credit; the federally facilitated SHOP; and the medical loss ratio program. To view the final rule, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-03-11/pdf/2013-04902.pdf

March 7, 2013: HHS Approves Four More States for Health Insurance Marketplaces The Department of Health and Human Services (HHS) announced that four more states—Iowa, Michigan, New Hampshire, and West Virginia—have been conditionally approved to operate state partnership marketplaces. The new conditional approvals bring the total number of states that have been conditionally approved to partially or fully run their marketplace to 24 states and the District of Columbia. For more details on the new approvals, click here: http://www.hhs.gov/news/press/2013pres/03/20130307a.htmlMarch 1, 2013: CMS Releases Draft Letter on Exchanges CMS issued a draft letter to issuers on Federally-facilitated and State Partnership Exchanges. This letter provides Qualified Health Plan (QHP) issuers in Federally-facilitated Exchanges (FFE) and Federally-facilitated SHOPs (FF-SHOP), including State Partnership Exchanges, with operational and technical guidance to help them participate in the exchanges. Comments are due to CMS by March 15, 2013. For the full text of the letter, go to: http://cciio.cms.gov/resources/files/issuer-letter-3-1-2013.pdf

March 1, 2013: HHS Announces Notice of Benefit and Payment Parameters The final rule for benefit and payment parameters expands upon the standards set forth in earlier rules and provides further information on the permanent risk adjustment, transitional reinsurance and temporary risk corridors programs, advance payments of the premium tax credit, cost-sharing reductions, medical loss ratio, and the Small Business Health Options Program (SHOP). Click here for more information: http://cciio.cms.gov/resources/factsheets/paymentnotice-3-1-2013.htmlFebruary 22, 2013: HHS Releases Final Rule on Health Insurance Market Reforms HHS released a final rule that implements five key provisions of the Affordable Care Act (ACA) applicable to non-grandfathered health plans: guaranteed availability, fair health insurance premiums, guaranteed renewability, single risk pool, and catastrophic plans. The rule also amends certain provisions of the rate review program. Click here for more information: http://www.hhs.gov/news/press/2013pres/02/20130222a.html

February 21, 2013: CMS Announces First Recipients of State Innovation Model Awards The State Innovation Models Initiative provides up to $300 million to support the development and testing of models for multipayer payment and health care delivery system transformation. The CMS Innovation Center announced that 25 states will receive awards under the program. Click here for more details: http://www.hhs.gov/news/press/2013pres/02/20130221a.html

February 21, 2013: CMS Releases Bulletin on MAGI-Based Eligibility Verification Plans CMS provided states with the following bulletin on the verification plans required for both Medicaid and the Children’s Health Insurance Plan (CHIP), the Modified Adjusted Gross Income (MAGI)-based plan template, and a review of the final verification regulations: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-02-21-13.pdf

February 21, 2013: HHS OIG Report Finds Most States Anticipate Implementing Streamlined Eligibility and Enrollment by 2014 The HHS Office of Inspector General conducted the following survey regarding states’ readiness to implement streamlined eligibility and enrollment systems for state health subsidy programs under ACA: https://oig.hhs.gov/oei/reports/oei-07-10-00530.pdf

February 20, 2013: HHS Releases Final Rule on Essential Health Benefits HHS released the final rule that outlines health insurance issuer standards for essential health benefits, the core package of benefits that health insurance issuers must cover both inside and outside the health insurance exchanges or marketplaces. The rule allows states to select a benchmark plan from options offered in the market which are equal in scope to a typical employer plan. The final rule expands coverage of mental health and substance use disorder services, including behavioral health treatment. To access the rule, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-02-25/pdf/2013-04084.pdf

February 20, 2013: CCIIO Releases FAQs on Plan Management The Center for Consumer Information and Insurance Oversight (CCIIO) released FAQs describing some additional flexibility for states in the area of state evaluation of plan-management activities of health plans and issuers: http://cciio.cms.gov/resources/files/plan-management-faq-2-20-2013.pdfFebruary 15, 2013: HHS Announces Strong Start Awards HHS announced 27 recipients of new Strong Start for Mothers and Newborns awards. The program provides funds for states, caregivers, and others to find new ways to prevent significant, long-term health problems for high-risk pregnant women and newborns enrolled in Medicaid or CHIP. To view the awardees, click here: http://innovation.cms.gov/initiatives/strong-start-strategy-2/index.html

February 11, 2013: ASPE Releases Brief on MAGI Conversion The Office of the Assistant Secretary for Planning and Evaluation (ASPE) released the following report to help states implement the modified adjusted gross income (MAGI) conversion from Medicaid and CHIP data: http://aspe.hhs.gov/health/reports/2013/MAGIHowTo/rb.cfm

February 2013: MACPAC Releases Overview of Medicaid and CHIP The Medicaid and CHIP Payment and Access Commission (MACPAC) released the following report that describes Medicaid and CHIP in the context of the health care system, including legislative history, benefits, spending, financing, and delivery arrangements: http://tinyurl.com/aq7wzl9February 8, 2013: CMS Publishes Final Rule on Transparency Reporting CMS released the final rule that will require applicable manufacturers of drugs, devises, biological, or medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) to annually report to the secretary of HHS certain payments or transfers of value provided to physicians or teaching hospitals. The rule also requires certain organizations to report annually certain physician ownership or investment interests. Click here for more information: http://www.gpo.gov/fdsys/pkg/FR-2013-02-08/pdf/2013-02572.pdf

February 7, 2013: CMS Issues Proposed Rule on Reducing Medicare/Medicaid Regulatory Provisions CMS published the following proposed rule that would reform Medicare regulations, streamline standards health care providers must meet to participate in Medicare and Medicaid, and increase the flexibility of health care professionals: http://www.gpo.gov/fdsys/pkg/FR-2013-02-07/pdf/2013-02421.pdf

February 6, 2013: HHS Announces New Children’s Electronic Health Record Format The Department of Health and Human Services (HHS) announced the new format, which was authorized by the Children’s Health Insurance Program Reauthorization Act (CHIPRA). It includes a minimum set of data elements and applicable data standards that can be used as a blueprint. For more information, go to: http://www.ahrq.gov/news/press/pr2013/childehrpr.htm February 6, 2013: CMS Releases ACA FAQs on Medicaid CMS releasedanswers to frequently asked questions on Medicaid and ACA that cover a range of issues including federal medical assistance percentages (FMAPs) for the newly eligible and expansion states, transitioning to modified adjusted gross income (MAGI), coverage for children and pregnant women, and future guidance for the Basic Health Plan. The document is available at: http://www.medicaid.gov/State-Resource-Center/Frequently-Asked-Questions/Downloads/ACA-FAQ-BHP.pdf February 2013: ASPE Publishes Brief on Data Sources for MAGI Conversions The Office of the Assistant Secretary for Planning and Evaluation (ASPE) published the following paper that provides states with technical specifications on data sources as they consider the MAGI conversion options: http://aspe.hhs.gov/health/reports/2013/sipp/ib.cfm

February 1, 2013: CMS Releases Guidance on Increased FMAP for Certain Preventive Services The Affordable Care Act (ACA) included a one percentage point increase in the Federal Medical Assistance Percentage (FMAP), effective January 1, 2013, for certain preventive services and adult vaccines. CMS issued the following guidance to states on claiming this enhanced FMAP: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-13-002.pdf

February 1, 2013: IRS Issues Final Rules Governing Health Insurance Premium Tax Credits The Internal Revenue Service (IRS) issued final regulations in which it maintained its previous interpretation that the test for determining whether employer-sponsored coverage is affordable is based on an employee’s cost toward self-only coverage, and if that individual coverage is affordable then the worker and related individuals would not be able to access premium tax credits for exchange coverage: http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/html/2013-02136.htm

January 30, 2013: Federal Agencies Publish Proposed Rules on Minimum Essential Coverage and Shared Responsibility Payments CMS and the IRS published two proposed rules for determining eligibility for exemption from the “shared responsibility” payment for not maintaining minimum essential coverage under ACA. The individual shared responsibility provisions call for each individual to have basic health insurance coverage or minimum essential coverage, qualify for an exemption, or make a shared responsibility payment when filing a federal income tax return. A summary of the proposals, with links to the Federal Register notices, can be found at: http://tinyurl.com/amtdv2w

January 24, 2013: CMS Provides Medicaid and CHIP Updates CMS sent a bulletin to states to provide information released on the children’s core set of health care quality measures as well as performance indicators for Medicaid and CHIP business functions. CMS is seeking public input on business process performance indicators in association with the development of new information technology systems for the expansion of Medicaid eligibility and the health insurance exchanges. Click here for more details: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-01-24-13.pdf

January 22, 2013: CMS Releases Eligibility and Enrollment Provisions for Exchanges, Medicaid, CHIP CMS released a proposed rule outlining the relevant eligibility and enrollment provisions for the new health exchanges, Medicaid, and the Children’s Health Insurance Program (CHIP). The proposed rule implements provisions included in the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148). To view a copy of the new regulations, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-01-22/pdf/2013-00659.pdf

January 17, 2013: HHS Announces $1.5 Billion in Exchange Establishment Grants to 11 States HHS announced the award of $1.5 billion in new Exchange Establishment Grants to 11 states: California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, and Vermont. To read more about the grants, click here: http://www.hhs.gov/news/press/2013pres/01/20130117a.htmlJanuary 15, 2013: CMS Releases Health Home Guidance CMS released new guidance related to health homes, as authorized under section 2703 of the Affordable Care Act (ACA). The guidance, which focuses on a recommended set of health care quality measures for assessing the health home service delivery model, is available at: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/SMD-13-001.pdfJanuary 7, 2013: HRSA Proposes New Information Collection for Maternal and Child Health (MCH) Block Grant As a result of the ACA, HRSA is proposing a new data collection to collect health services budget information from MCH recipients. The new form will collect information on medical services and program support services in addition to data on individuals served. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2013-01-07/pdf/2013-00030.pdf

January 3, 2013: CCIIO Releases Guidance on the State Partnership Exchange The Center for Consumer Information and Insurance Oversight (CCIIO) announced new guidance to states on the State Partnership Exchange, which outlines state functions, activities, and responsibilities. The guidance is available at: http://cciio.cms.gov/resources/files/partnership-guidance-01-03-2013.pdfDecember 28, 2012: CMS Issues Letter on ACA MAGI Provisions CMS release guidance to states on converting current net income eligibility thresholds to equivalent modified adjusted gross income (MAGI) thresholds in Medicaid and the Children’s Health Insurance Program (CHIP). It discusses various options for conversion to MAGI eligibility standards, the timeline and process for plan submission, and the availability of technical assistance. Click here to access the guidance: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO12003.pdf

December 20, 2012: Three More States Receive Approval for Exchange Plans CMS granted conditional approval to operate a state-based exchange to Minnesota and Rhode Island and the first conditional approval of a state partnership exchange in Delaware. More details can be found at: http://www.hhs.gov/news/press/2012pres/12/20121220a.html

December 20, 2012: HRSA Announces Community Health Center HIT Grants The Health Resources and Services Administration (HRSA) announced $18 million in Affordable Care Act (ACA) funds to support community health centers through implementation and adoption of health information technology (HIT): http://www.hrsa.gov/about/news/pressreleases/121220healthcenternetworks.html December 19, 2012: HHS Awards $80 Million to School-Based Health Centers ACA provided $200 million in funding from FYs 2010-2013 for the School-Based Health Center Capital Program. The Department of Health and Human Services (HHS) announced FY 2013 awards under the program. For more information and to view the awards, click here: http://www.hhs.gov/news/press/2012pres/12/20121219a.html

December 14, 2012: Three More States Receive Approval for State Exchange Plans CMS granted conditional approve to operate a state-based exchange to the District of Columbia, Kentucky, and New York. The announcement follows the same type of approvals provided to Colorado, Connecticut, Massachusetts, Maryland, Oregon, and Washington. Click here for more details: http://tinyurl.com/bsu8ywl

December 12, 2012: CMS Approves Ohio’s Participation in Federal Alignment Initiative Through this new initiative, CMS is partnering with states to test models that better align the financial incentives of Medicare and Medicaid to provide dual-eligible enrollees with better care. To date, CMS has a memorandum of understanding (MOU) with three states: Massachusetts, Washington, and Ohio. More details on the initiative are available at: http://www.innovations.cms.gov/initiatives/Financial-Alignment/index.htmlDecember 10, 2012: HHS Releases Additional Guidance on ACA; Partial Expansion Won’t Quality for Higher Match HHS sent a letter to governors outlining additional guidance on the implementation of ACA. HHS announced that states must fully expand Medicaid up to 138% of the federal poverty level in order to receive the enhanced funding. The secretary of HHS also announced conditional approval to state exchange plans submitted by Colorado, Connecticut, Massachusetts, Maryland, Oregon, and Washington. HHS sent a separate letter to territories regarding ACA. The letters are available at: http://cciio.cms.gov/resources/lettersandnews/index.html#hie

December 7, 2012: HHS Releases Proposed Rule on Benefit and Payment Parameters for 2014 HHS published in the Federal Register a proposed rule that provides further details on policies such as the risk adjustment, reinsurance and risk corridors programs, advance payments of the premium tax credit, and cost-sharing reductions. It also includes a proposal for a user fee for health insurance issuers participating in a federally facilitated exchange. More details are available here: http://www.gpo.gov/fdsys/pkg/FR-2012-12-07/pdf/2012-29184.pdf

December 3, 2012: CMCS Provides Coverage Information for Individuals with Behavioral Health Disorder The Center for Medicaid and CHIP Services (CMCS) provided information to states regarding services and supports to meet the needs of individuals with mental health or substance abuse disorders. The bulletin describes principles/coverage goals, resources for states, and future guidance. Click here for more information: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-12-03-12.pdf

November 30, 2012: OPM Releases Proposed Regulations for Multi-State Plans The Office of Personnel Management (OPM) published a Notice of Proposed Rulemaking to implement the Multi-State Plan Program (MSPP). The rule outlines the process by which OPM will establish the MSPP to offer private insurance products on the exchanges, as well as to establish standards and requirements for MSPP issuers and Multi-State plans (MSPs). Under the proposed rule, health insurance issuers will offer at least two MSPs on each of the Affordable Insurance Exchanges through contract with OPM. OPM will administer the MSPP consistent with state insurance laws and in coordination and cooperation with states. Comments are due January 4, 2013. OPM intends to publish a final rule early in 2013. For more information, go to: http://www.opm.gov/insure/mspp/index.asp

November 30, 2012: CCIIO Announces Additional Application Date for Exchange Establishment Grants The Center for Consumer Information and Insurance Oversight (CCIIO) announced an additional application deadline of December 28, 2012, for Level I and Level II grants for supporting the establishment of health insurance exchanges. More details can be found at: http://cciio.cms.gov/resources/fundingopportunities/index.html#peg

November 15, 2012: HHS Further Extends Health Insurance Exchange Deadlines HHS released its second announcement extending the deadline for states to submit their letters of intent to establish a state-based exchange. The latest deadline is December 14, 2012, which was pushed back from the November 16 deadline. Click here for more information: http://www.healthcare.gov/law/resources/letters/index.html

November 9, 2012: HHS Extends Deadlines for Exchanges HHS announced that the deadlines for states seeking to operate either a state-based or partnership exchange under ACA have been extended. Specifically, states electing to operate a state-based exchange must submit a declaration letter by November 16, but the blueprint is not due until December 14, 2012. States electing to operate a state partnership exchange can submit their letter and blueprint on a rolling basis until February 15, 2013. More information is available at: http://www.ffis.org/sites/ffis.org/files/public/HHS_Letter_Exchange.pdf

November 1, 2012: CMS Releases Final Rule Implementing Higher Medicaid Payments to Primary Care Physicians The Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register to implement ACA provision that provides increased payments (at the Medicare rate in effect in 2013 and 2014) to certain primary care physicians for specified Medicaid primary care services. The minimum payment level applies to specified primary care services furnished by a physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine, and also applies to services rendered by those provider types paid by Medicaid managed care plans. States will receive 100% federal financial participation for the difference between the Medicaid state plan payment amount and the applicable Medicare rate. The rule also includes information on how this policy applies to the Vaccines for Children (VFC) program. Click here for more information: http://www.hhs.gov/news/press/2012pres/11/20121101d.html

October 11, 2012: HHS Announces National Health Service Corps Awards In FY 2012, the National Health Service Corps made nearly 4,600 loan repayment and scholarship awards, totaling $229.4 million. More details are available on the HHS website: http://www.hhs.gov/news/press/2012pres/10/20121011a.html

September 2012: GAO Issues Report on Prevention and Public Health Fund (PPHF) The Government Accountability Office (GAO) released a report that details those activities funded from the PPHF in FYs 2010 and 2011. The report describes the activities, the process/criteria used to allocate funds, and HHS’s reporting of the outcomes. The full report can be accessed at: http://www.gao.gov/assets/650/648310.pdf

October 3, 2012: ACF Awards Supplement Grants Under Health Profession Opportunity Grants Program The Administration for Children and Families (ACF) announces the award of single-source program expansion supplements to all existing grantees under this program. A list of awards by state is available at: http://www.gpo.gov/fdsys/pkg/FR-2012-10-03/pdf/2012-24310.pdf

October 2, 2012: HRSA Awards Additional Funding to Nursing Assistant and Home Health Aide (NAHHA) Grantees The Health Resources and Services Administration (HRSA) announced it is awarding $1 million to 10 existing NAHHA grantees to develop, implement, and evaluate enhanced training programs. Click here for more information: http://www.gpo.gov/fdsys/pkg/FR-2012-10-02/pdf/2012-24250.pdfSeptember 28, 2012:CCIIO Announces Additional Awards for Consumer Oriented and Operated Plan (CO-OP) Program The Center for Consumer Information and Insurance Oversight (CCIIO) announces awards for the CO-OP program on a rolling basis. Updated award information can be found at: http://www.healthcare.gov/news/factsheets/2012/02/coops02212012a.html

September 28, 2012: CMS Announces Awards for Initiative to Reduce Avoidable Hospitalizations The Centers for Medicare & Medicaid Services (CMS) announced cooperative agreement awards for seven organizations that will be partnering with nursing facilities and state Medicaid programs to implement the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents: http://innovation.cms.gov/initiatives/rahnfr/

September 27, 2012: HHS Announces Affordable Insurance Exchange EstablishmentGrants The Department of Health and Human Services (HHS) announced that Arkansas, Colorado, Kentucky, Massachusetts, and the District of Columbia received a new round of exchange establishment grants. More details are available at: http://www.hhs.gov/news/press/2012pres/09/20120927a.html

September 27, 2012: HRSA Announces New Community Health Center Awards The Health Resources and Services Administration (HRSA) announced new grants, funded by the Affordable Care Act (ACA), to enhance quality of care at community health centers. More information, including a list of grantees, can be found at: http://www.hhs.gov/news/press/2012pres/09/20120927b.html

September 25, 2012: HHS Announces Awards Under New Mental and Behavioral Health Education and Training Program HHS awarded $9.8 million to 24 graduate social work and psychology schools and programs under the Mental and Behavioral Health Education and Training grant. Click here for more information and for a list of awards by state: http://www.hrsa.gov/about/news/2012tables/120925mentalandbehavioral.html

September 14, 2012: HHS Updates State Enrollment Data for Pre-Existing Condition Insurance Plan (PCIP) HHS updated its chart that shows the number of people enrolled in the PCIP program by state as of July 31, 2012: http://www.healthcare.gov/news/factsheets/2012/09/pcip09142012a.htmlSeptember 13, 2012: The Centers for Medicare and Medicaid Services (CMS) Revamps Medicaid Recovery Audit Contractor (RAC) Website The enhanced website includes state-reported information on the RAC program and user-friendly charts and data: http://w2.dehpg.net/RACSS/Map.aspx

August 31, 2012: HHS Announces Consumer Operated and Oriented Plan Grants HHS announced new low-interest loans to nonprofits under the Consumer Operated and Oriented Plan (CO-OP) program. To date, a total of 20 nonprofits offering coverage in 20 states have been awarded $1.6 billion.To view the full announcement, click here: http://www.healthcare.gov/news/factsheets/2012/02/coops02212012a.htmlAugust 24, 2012: CMS Extends Deadline for State Innovation Models Applications CMS extended the deadline to September 24, 2012, for its new competitive funding opportunity for states to design and test multi-payer payment and delivery models: http://www.innovations.cms.gov/

August 24, 2012: HHS Announces New Health Care Standards, Delays New Coding HHS announced a final rule to establish a unique health plan identifier, in an effort to simplify the billing process. In addition, the rule makes final a one-year delay, from October 1, 2013 to October 1, 2014, in the compliance date for use of new codes that classify diseases and health problems. For more details, go to: http://www.hhs.gov/news/press/2012pres/08/20120824e.html

August 24, 2012: New Consumer Assistance Program Grants Awarded The Center for Consumer Information & Insurance Oversight (CCIIO) announced $20 million in new funding for 24 states and territories under the Consumer Assistance Program. For a list of awardees as well as how each jurisdiction will use the new resources, click here: http://www.healthcare.gov/news/factsheets/2010/10/cap-grants.html

August 23, 2012: HHS Announces New Exchange Establishment Grants HHS announced that eight states (California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont) have received new grants to help support the establishment of the health insurance exchanges: http://www.hhs.gov/news/press/2012pres/08/20120823a.html

August 23, 2012: HHS Releases New Requirements for Electronic Health Records HHS issued the stage 2 final requirements that hospitals and providers must meet to qualify for Medicare and Medicaid incentive payments as well as the criteria that electronic health records must meet to achieve certification: http://www.hhs.gov/news/press/2012pres/08/20120823b.html

August 16, 2012: HHS Announces Epidemiology and Laboratory Capacity Awards HHS announced awards of $48.8 million to strengthen state epidemiology, laboratory, and health information systems. For more information, click here: http://www.hhs.gov/news/press/2012pres/08/20120816a.html

August 14, 2012: CMS Issues Final Blueprint for Approval of Health Insurance Exchanges CMS issued the final blueprint for approval of state-based and state partnership insurance exchanges. States may use the blueprint to demonstrate how their exchange will work to offer a wide range of competitively priced private health insurance options. The blueprint also sets forth the application process for states seeking to enter into a partnership exchange. CMS notes that states should submit their exchange blueprints by November 16, 2012, for their exchanges to be considered for certification on January 1, 2013. More information is available at: http://www.cciio.cms.gov/resources/files/hie-blueprint-081312.pdf.

August 10, 2012: CMS Announces New Independence at Home Demonstration Participants Through the Independence at Home Demonstration, CMS is partnering with health care providers to test the effectiveness of providing chronically ill Medicare beneficiaries with primary care services in the home. In April, CMS announced the names of individual practices selected to participate in the Demonstration. CMS also allowed multiple practices to apply to participate in the demonstration as a consortium rather than as individual practices. CMS announced the three consortia selected to participate (located in Illinois, Florida, and Virginia.) More information is available at: http://innovation.cms.gov/initiatives/Independence-at-Home

August 10, 2012: CMS Seeks Comment on New Information Collection for Medicaid Demonstration CMS seeks comment on new data collection for grantees under the Medicaid Incentives for Prevention of Chronic Diseases program. The information will be used for performance monitoring and evaluation. Click here for more information: http://www.gpo.gov/fdsys/pkg/FR-2012-08-10/pdf/2012-19606.pdf

August 10, 2012: HHS Publishes Interim Final Rule on Health Care Billing HHS published an interim final rule with comment period in the Federal Register to implement the Affordable Care Act (ACA) provisions regarding the adoption of operating rules for the health care electronic funds transfers (EFT) and remittance advice transaction. This rule is designed to reduce administrative time and costs. To view the rule, click here: http://www.gpo.gov/fdsys/pkg/FR-2012-08-10/pdf/2012-19557.pdf

August 10, 2012: HRSA Seeks Comment on New Data Collection for Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) The Health Resources and Services Administration (HRSA) seeks comment on proposed data collection and reporting forms to be used to track MIECHV grantees’ progress in demonstrating improvement under each benchmark area as well as provide an overall picture of the population served: http://www.gpo.gov/fdsys/pkg/FR-2012-08-10/pdf/2012-19665.pdf

August 10, 2012:HHS Updates State Enrollment Data for Pre-Existing Condition Insurance Plan (PCIP) HHS updated its chart that shows the number of people enrolled in the PCIP program by state as of June 30, 2012: http://www.healthcare.gov/news/factsheets/index.html

August 8, 2012: CMS Releases Information about Medicaid Expansion CMS officials confirmed that states that expand their Medicaid programs under provisions in ACA are able to make enrollment cuts in the future. Cindy Mann, director of the Center for Medicaid and CHIP Services at CMS, indicated that states that initially choose to participate in the Medicaid expansion could later drop that coverage. States face no deadline for deciding when and if they will expand Medicaid under the ACA according to CMS. Many questions regarding the Medicaid expansion in light of the Supreme Court’s decisions have been sent to federal officials and additional guidance will be forthcoming. July 2012: ACF Updates Interoperability Toolkit ACF updated its toolkit, which is a compendium of federal policies, regulations, guidance, and other tools and resources for states in the planning and development of IT to foster interoperability between health and human services programs serving the same population. This updated toolkit is designed to support efforts to link human services and health insurance exchanges. The toolkit is available at: http://transition.acf.hhs.gov/sites/default/files/assets/acf_toolkit_july_2012_final.pdfAugust 2, 2012: GAO Issues Report on States’ Implementation of the Affordable Care Act (ACA) The Government Accountability Office (GAO) released a report that examined three questions: 1) What are states’ responsibilities for implementing the Medicaid expansion, 2) What actions have selected states taken to prepare for the expansion and what challenges have they encountered, and 3) What are states’ views on the fiscal implementation of the expansion on state budget planning. The report and its findings are available at: http://www.gao.gov/assets/600/593210.pdf

August 2, 2012: HHS Announces Physician Assistant Training Grants HHS announced $2.3 million in grants to train primary care physician assistants. Funding priority was given to grantees that have strong recruitment, retention, and education programs for veteran applicants and students. More information, including the awards by state, can be found at: http://www.hhs.gov/news/press/2012pres/08/20120802a.html August 1, 2012: CMCS Releases Bulletin on Provider Screening Procedures The Center for Medicaid and CHIP Services (CMCS) informed states that the Excluded Parties List System (EPLS) has migrated to the System for Award Management. Federal regulations implementing new ACA provisions require that state Medicaid agencies check the EPLS no less frequently than monthly. Click here to view the guidance: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-08-01-12.pdfJuly 30, 2012: CMS Announces Five Hospitals Participating in Graduate Nurse Education Demonstration CMS announced those hospitals participating in this new demonstration, included in the Affordable Care Act (ACA), to provide clinical training to advanced practice registered nursing (APRN) students. The purpose of this demonstration is to provide APRNs with the skills necessary to provide primary care, preventive care, transitional care, chronic care management, and other services appropriate for Medicare beneficiaries. Click here for more information, including a listing of the sites and an updated fact sheet: http://www.innovation.cms.gov/initiatives/gne/

July 26, 2012: HHS and DOJ Announce Public-Private Partnership to Prevent Health Care Fraud HHS and the Department of Justice (DOJ) announced a new partnership designed to share information and best practices to improve detection and prevent payment of fraudulent health care billings. For more details, including a list of organizations and government agencies that have joined the partnership, click here: http://www.hhs.gov/news/press/2012pres/07/20120726a.html

July 25, 2012: SAMHSA Awards $22 Million for Screening, Brief Intervention, and Referral to Treatment (SBIRT) The Substance Abuse and Mental Health Service Administration (SAMHSA) awarded more than $22 million to three states (Arizona, Iowa, and New Jersey) for expanding SBIRT services for adults in primary care and community health settings. These awards were funded by ACA’s Prevention and Public Health Fund. Click here for more information: http://www.samhsa.gov/newsroom/advisories/1207254120.aspx

July 23, 2012: HHS OIG Report Finds that HHS Failed to Report all Improper Payments The HHS Office of Inspector General (OIG) released the following report that found the department did not identify all high-dollar improper payments in its FY 2010 quarterly reports. HHS disagreed with the findings. The full report can be accessed at: http://oig.hhs.gov/oas/reports/region2/21101007.asp

July 24, 2012: CBO Updates Estimates of ACA Based on Supreme Court Decision The Congressional Budget Office (CBO) has updated its estimates of the budgetary effects of the health insurance coverage provisions of ACA to take into account the Supreme Court decision. The report projects a net savings to the federal government because the reductions in spending from lower Medicaid enrollment are expected to more than offset the increase in costs from greater participation in the health care exchanges. The report is available at: http://www.cbo.gov/publication/43472

July 23, 2012: HHS Seeks Comment on Plan to Prevent Health Care-Associated Infections HHS is seeking comment from state and local public health agencies and other entities on its plan for preventing and reducing health care-associated infections in long-term care facilities: http://www.gpo.gov/fdsys/pkg/FR-2012-07-23/pdf/2012-17925.pdf

July 23, 2012: Administration for Community Living (ACL) Proposes New Data-Collection Activity for Chronic Disease Program ACL published the following notice in the Federal Register on new data-collection activities to support program monitoring for the Empowering Older Adults and Adults with Disabilities through Chronic Disease Self-Management Education (CDSME) programs, which are funded by the ACA Prevention and Public Health Fund: http://www.gpo.gov/fdsys/pkg/FR-2012-07-23/pdf/2012-17752.pdf

July 23, 2012: GAO Releases Report on Children’s Health Insurance The Government Accountability Office (GAO) released the following report that estimates the extent to which 1) uninsured children would be eligible for Medicaid, CHIP, or the premium tax credit under ACA, and 2) children would experience a change in eligibility among the programs because of income changes: http://www.gao.gov/assets/600/591797.pdf

July 20, 2012: CMS Issues Final Rule on Essential Health Benefits CMS published a final rule in the Federal Register outlining the data that health plans must provide to determine whether they meet essential health benefit standards, and establishing a process for accrediting entities to certify qualified health plans. The final rule, which becomes effective in 30 days, is available at: http://www.gpo.gov/fdsys/pkg/FR-2012-07-20/pdf/2012-17831.pdf

July 19, 2012: HHS Announces State Health Care Innovative Initiative HHS announced new funding for states to design and test improvements to their health care systems. The State Innovation Models initiative provides $275 million in competitive funding for states. States can apply for either model testing awards to assist in implementing models already developed or model design awards that will provide funding and technical assistance as models are developed. Up to five states will be chosen for the initial round of model testing awards and up to 25 states will be chosen for model design awards. Applications are due by September 17, 2012, with an anticipated award date of November 2012. More information is available at: http://www.hhs.gov/news/press/2012pres/07/20120719a.html

July 13, 2012: HHS Releases Two Letters to Governors on Medicaid Expansion Following the Supreme Court’s ruling on ACA, the secretary of HHS sent a letter to each governor. According to the letter, the Supreme Court’s decision on Medicaid did not affect other provisions of the law other than that a state would not lose federal funding for the existing Medicaid program if the state did not expand Medicaid. HHS is planning on having meetings this summer to discuss these topics and the letter includes the dates of this meetings. More details are available at: http://www.ffis.org/sites/ffis.org/files/public/Secretary_Sebelius_Letter_to_the_Governors_071012.pdf

Another letter, from CMS Acting Administrator Tavenner, explained that there is no specific date by which states must decide if they will participate in the Medicaid expansion. In addition, she clarified that a state can receive the enhanced funding for Medicaid IT costs even if it has not decided whether to run its own exchange or expand Medicaid (or if it decides not to do so, will not have to return the funds). The letter is available at: http://www.ffis.org/sites/ffis.org/files/public/CMS_Response_VA.pdf

July 10, 2012: CMS Releases Guidance on Integrated Care Models CMS released two guidance documents to states on payment and service delivery reforms in Medicaid, referred to as Integrated Care Models. The letters describe the policy considerations and options available to states.

July 2, 2012: CMS Revises Strong Start Funding Opportunity CMS revised the Strong Start funding opportunity to shift the responsibility for obtaining linked vital statistics and Medicaid claims and utilization data from the applicant to CMS. The new application deadline is August 9, 2012, with anticipated awards in early October. More information can be found at: http://www.innovations.cms.gov/initiatives/Strong-Start/StrongStart_FactSheet.html July 2, 2012: CMS Updates Essential Health Benefit Small Group Guidance CMS published guidance to facilitate states’ selection of the benchmark plans that will serve as the reference plans for the essential health benefits (EHB). It provides an updated list of the three largest small-group insurance products ranked by enrollment for each state. Click here for more information: http://cciio.cms.gov/resources/files/largest-smgroup-products-7-2-2012.pdf.PDF

June 21, 2012: CMS Seeks Public Input on MAGI Conversion CMS is seeking comments on two potential methodologies for converting current Medicaid and Children’s Health Insurance Program (CHIP) net income eligibility standards to equivalent modified adjusted gross income (MAGI) standards. Comments must be submitted by July 23, 2012. More details are available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-06-21-12.pdf

June 20, 2012: HHS Announces New Grants to Expand Community Health Centers HHS awarded more than $128 million in ACA funds for community centers in 41 states, the District of Columbia, Puerto Rico, and the Northern Mariana Islands. More information on these Health Center New Access Point grants, including a list of awards, are available at: http://www.hhs.gov/news/press/2012pres/06/20120620a.html

June 13, 2012: GAO Releases Report on State Option for Home- and Community-Based Services GAO issued the following report to assess the implementation status of the four Medicaid home- and community-based services options included in ACA: http://www.gao.gov/products/GAO-12-649 June 2012: CMS Releases National Health Spending Report CMS released its annual projections for health care growth rates. According to the report, overall U.S. health spending is projected to grow 4.0% on average for 2011-2013. Starting 2014, CMS projects national health spending will rise by 7.4% as a result of major coverage expansions. The report can be accessed at: http://content.healthaffairs.org/content/early/2012/06/11/hlthaff.2012.0404.full.htmlJune 18, 2012: ACF Proposes New Data Collection for Health Professions Opportunity Grants The Administration for Children and Families (ACF) is seeking comment on new data-collection activities as part of a study to evaluate the effectiveness of approaches used by Health Professions Opportunities Grants (HPOG) grantees on providing recipients of Temporary Assistance for Needy Families (TANF) and other low-income individuals with opportunities in the health care field: http://www.gpo.gov/fdsys/pkg/FR-2012-06-18/pdf/2012-14656.pdf

June 15, 2012 MACPAC Releases Report to Congress on Medicaid and Children’s Health Insurance Program (CHIP) The Medicaid and CHIP Payment Access Commission (MACPAC) released its June 2012 report, which focuses on the role of Medicaid and CHIP as purchasers of care as well as access to care issues: http://www.macpac.gov/reports

June 15, 2012: HHS Announces Second (and Final) Batch of Health Innovation Awards HHS announced the recipients of 81 new health care innovation awards, which support projects designed to deliver high-quality medical care, enhance the health care workforce, and reduce costs. More information on the awards can be found at: http://www.hhs.gov/news/press/2012pres/06/20120615a.html

June 14, 2012: HHS Announces Funding Opportunity to Test Elder Abuse Prevention Strategies HHS announced $5.5 million for states and tribes to test ways to prevent elder abuse, neglect, and exploitation. This funding is part of the Elder Justice Act, which was included in the Affordable Care Act (ACA), and funded with ACA Prevention and Public Health funds. More details are available at: http://www.hhs.gov/news/press/2012pres/06/20120614a.htmlJune 8, 2012: CMS Seeks Comment on New Medicaid and CHIP System, Announces Webinars The Centers for Medicare & Medicaid Services (CMS) is seeking comment on a new system to ensure timely approval of Medicaid and Children’s Health Insurance Program (CHIP) state plans, waivers, and demonstrations, and to provide a repository for program data. In addition, it announced webinars to demonstrate the concepts associated with the new Medicaid and CHIP workflow system. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2012-06-08/pdf/2012-13869.pdf

June 8, 2012: CCIIO Announces Additional Awards for Consumer Oriented and Operated Plan (CO-OP) Program The Center for Consumer Information and Insurance Oversight (CCIIO) announces awards for the CO-OP program on a rolling basis. Details on the new awards are can be found at: http://www.healthcare.gov/news/factsheets/2012/02/coops02212012a.html

June 7, 2012: HHS Announces New Funding Opportunity for Consumer Assistance Program HHS announced a new round of funding to support the state-based Consumer Assistance Program. In addition, it released a report on existing Consumer Assistance Program grantees. Click here for more information: http://www.hhs.gov/news/press/2012pres/06/20120607a.html

June 6, 2012: CMS Announced Participating Payers for Comprehensive Primary Care Initiative CMS announced agreements with 45 commercial, federal, and state insurers in the seven selected geographic markets that were chosen for the Comprehensive Primary Care Initiative, which is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care: http://www.innovations.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/index.html

June 5, 2012: CMCS Releases Bulletin on New Aging and Disability Resource Center (ADRC) Funding The Center for Medicaid and CHIP Services (CMCS) released the following information bulletin on the release of $25 million in Affordable Care Act (ACA) funding to help states strengthen and expand access to home and community-based long-term care services and supports: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-06-05-12.pdf

June 5, 2012: CCIIO Seeks Comment on Health Care Reform Insurance Web Portal Updates CCIIO is seeking comment on updates to its web portal where states log in to the system to provide information on issuers in their state and various websites for consumers. Specifically, it is mandating that insurance issuers verify and update their information on a quarterly basis and requesting that states verify state-submitted information on an annual basis. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2012-06-05/pdf/2012-13480.pdfJune 1, 2012: CMS Innovation Center Provides Additional Guidance for Initiative to Reduce Avoidable Hospitalizations The CMS Innovation Center posted to its website application guidance and updated frequently asked questions for its new initiative to reduce avoidable hospitalizations among nursing facility residents: http://www.innovations.cms.gov/initiatives/rahnfr/index.html

May 31, 2012: HHS Announces Funding Opportunity for Aging and Disability Resource Centers (ADRCs) HHS announced a new $25 million ACA funding opportunity to help states improve access to home and community-based long-term care services and supports. More details are available at: http://www.hhs.gov/news/press/2012pres/05/20120531d.html

May 30, 2012: CMS Announces Partnership to Improve Dementia Care in Nursing Homes CMS announced the Partnership to Improve Dementia Care, an initiative to ensure appropriate care and use of antipsychotic medications for nursing home patients. More details can be found at: http://tinyurl.com/86ekpyc

May 29, 2012: CMS Announces Requirements for Provider Screening Innovator Challenge CMS released the requirements and registration details of the Provider Screening Innovator Challenge, which is an innovation competition to develop a multistate, multiprogram provider screening software application to reduce fraud and abuse, and administrative costs. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2012-05-29/pdf/2012-12633.pdf

May 25, 2012: CMS Releases Bulletin on New Federal Register Publications CMS provided states with information on three recent Federal Register publications: the CMS Provider Screening Innovator Challenge, the final rule regarding disallowance of claims for federal financial participation, and the final rule to align certain provider qualifications between Medicaid and Medicare. In addition, the bulletin covers a new set of question and answers regarded the Affordable Care Act (ACA) implementation. The informational bulletin is available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-05-25-12.pdf

May 23, 2012: HHS Announces Awards for Family-to-Family Health Information Centers HHS announced $4.9 million in Affordable Care Act (ACA) funding to support Family-to-Family Health Information Centers. Click here for more information on the program and a list of grantees: http://www.hhs.gov/news/press/2012pres/05/20120523a.htmlMay 17, 2012: Updated State-by-State Enrollment in Pre-Existing Condition Insurance Plan (PCIP) HHS updated the list of states enrolled in a PCIP either run by the state or federal government as of March 31, 2012. To view the updated list, click here: http://www.healthcare.gov/news/factsheets/2012/05/pcip05182012a.html

May 16, 2012: CMS Issues Final Rule on Medical Loss Ratios CMS published the final rule governing regulations for the medical loss ratio (MLR) standards for health insurance issuers under the Patient Protection and Affordable Care Act (ACA, P.L. 111-148). The complete final rule can be accessed here: http://www.gpo.gov/fdsys/pkg/FR-2012-05-16/pdf/2012-11753.pdf

May 16, 2012: HHS Announces Six More States Receiving Affordable Insurance Exchange Grants HHS announced that six new states—Illinois, Nevada, Oregon, South Dakota, Tennessee, and Washington—will receive more than $181 million in grants to help implement the new Affordable Insurance Exchanges authorized under ACA. To read the full announcement, click here: http://www.hhs.gov/news/press/2012pres/05/20120516a.html

May 11, 2012: CMS Issues Proposed Rule on Payments for Primary Care Physicians and Charges for Vaccine Administration CMS issued a final rule implementing several provisions from the Patient Protection and Affordable Care Act (ACA, P.L. 111-148). The rule implements Medicaid payment rates for primary care physicians in calendar years (CYs) 2013 and 2014 and provides 100% federal financing for any increase in payment above the amounts that would be due for these services as of July 1, 2009. The proposed rule also updates the interim regional maximum fees that providers may charge for the administration of pediatric vaccines under the Vaccines for Children (VFC) program. More information on the proposed rule can be found here: http://www.gpo.gov/fdsys/pkg/FR-2012-05-11/pdf/2012-11421.pdf

May 11, 2012: HHS Notifies States of MIECHV Progress Reports HHS notified states that received funding under the ACA’s Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) that they must complete noncompeting continuation (NCC) progress reports in order to secure the release of FY 2012 and out-year grant funds. To view the notice, click here: http://www.gpo.gov/fdsys/pkg/FR-2012-05-11/pdf/2012-11377.pdf

May 8, 2012: HHS Announces First 26 Health Care Innovation Awards HHS announced the first round of Health Care Innovation awards totaling $122.6 million. The awards, authorized under ACA, aim to deliver high-quality medical care and enhance the health care workforce over the next three years. HHS’s announcement can be accessed here: http://www.hhs.gov/news/press/2012pres/05/20120508a.html

May 8, 2012: HHS Announces $122.6 Million in Health Care Innovation Awards HHS announced the first 26 health care innovation awards, an initiative focused on improving the quality and affordability of health care. More details, including a list of grantees, are available at: http://www.hhs.gov/news/press/2012pres/05/20120508a.htmlMay 1, 2012: HHS Announces Additional ACA Funding for Health Centers HHS awarded more than $728 million in Affordable Care Act (ACA) funds to support 398 renovation and construction projects. Click here for more information, including a listing of awards: http://www.hhs.gov/news/press/2012pres/05/20120501a.html April 30, 2012: CMS Modifies Strong Start Funding Opportunity CMS has modified the Strong Start for Mothers and Newborns funding opportunity announcement released in February 2012 to provide additional guidance and clarification. The modifications focus on eligibility, state data issues, required documentation, supplementing funds, indirect costs, and cost effectiveness. Click here for more information: http://innovation.cms.gov/initiatives/Strong-Start/index.html April 30, 2012: GAO Releases Report on Medicare and Medicaid Electronic Health Records (EHRs) The Government Accountability Office (GAO) released a report on the implementation of the Medicare and Medicaid EHRs program, which includes four recommendations to improve processes to verify providers meet the program’s requirements: http://www.gao.gov/products/GAO-12-481

April 26, 2012: HHS Announces New ACA Options for Community-Based Care HHS released the final rule on the Community First Choice Option, a new state plan option under Medicaid, and announced the participants in the Independence at Home Demonstration Program. In addition, HHS is seeking comment on a proposed rule on the Home and Community-Based Services state option. More information is available at: http://www.hhs.gov/news/press/2012pres/04/20120426a.html

April 20, 2012: HHS Announces New Funding Opportunity for Consumer Assistance Programs HHS announced that approximately $2.5 million in Consumer Assistance Program grant funds were not spent during the first grant cycle. As such, these funds are available through a new limited-competition funding opportunity for the 38 states and territories that successfully completed the first grant cycle. Click here for more information: http://cciio.cms.gov/programs/consumer/capgrants/ltdfacts.html

April 19, 2012: HHS Seeks Comment on Plan to Eliminate Health Care-Associated Infections (HAIs) HHS released an updated National Action Plan to eliminate HAIs. It also provided a state-by-state breakdown of HAIs in hospitals as well as state HAI prevention activities. More details are available at: http://www.hhs.gov/news/press/2012pres/04/20120419a.html

April 16, 2012: CMCS Releases Information Bulletin on ICD-10 Implementation and Waivers The Center for Medicaid and CHIP Services (CMCS) released the following bulletin to provide information on the delay in implementation of the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10), and a reminder of the instructions for approval of section 1915(c) home and community-based services waivers: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-04-16-12.pdfApril 9, 2012: HHS Announces Administrative Simplifications HHS announced a proposed rule that would implement several administrative simplification provisions of the Affordable Care Act (ACA). In addition, the rule delays the required compliance by one year, to October 1, 2014, for new codes used to classify diseases and health problems. For more information, go to: http://www.hhs.gov/news/press/2012pres/04/20120409a.html

April 3, 2012: HHS Announces $72 Million for MIECHV Grants HHS announced that 10 states will receive awards totaling $72 million under the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program created by the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148). More information about the new grants can be found here: http://www.hhs.gov/news/press/2012pres/04/20120403b.html

March 28, 2012: CMCS Releases Medicaid Information Technology Architecture (MITA) Framework, Version 3.0 The Center for Medicaid, CHIP and Survey & Certification (CMCS) announced the availability of MITA framework, version 3.0, which contains updated business procedures and rules to comply with new legislative requirements: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-03-28-12.pdf

March 23, 2012: HHS Seeks Comments on Home Visiting Information Collection HHS has launched a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting Program and is seeking comments on data-collection efforts needed for phase 1 of the study. Click here for details: http://www.gpo.gov/fdsys/pkg/FR-2012-03-23/pdf/2012-6977.pdf

March 23, 2012: CMS Releases Guidance on Nursing Home Initiative The Centers for Medicare & Medicaid Services (CMS) released the following information to inform states about a new opportunity to reduce avoidable hospitalizations among nursing facility residents that are eligible for both Medicare and Medicaid. Click here for more information, including details on the role of states: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-03-23-12.pdf

March 22, 2012: HHS Releases Update on Health Insurance Rates HHS determined that rate increases in nine states were “unreasonable” after an independent expert review. It also released a rate review report. For more information, go to: http://tinyurl.com/c3uxjph

March 21, 2012: CMS Publishes Notice on Early Retiree Reinsurance Program (ERRP) CMS issued a notice in the Federal Register to establish a timeframe by which plan sponsors participating in ERRP are expect to use reimbursement funds. CMS expects sponsors to use funds as soon as possible but no later than December 31, 2014. Click here for more information: http://www.gpo.gov/fdsys/pkg/FR-2012-03-21/pdf/2012-6728.pdf

March 21, 2012: CMS Issues Guidance on HIPAA Simplification CMS released a bulletin to states on the HIPAA administrative simplification provisions in ACA. Specifically, the bulletin describes standards for the adoption of operating rules for eligibility for a health plan and health care claim status transactions. Click here for more details: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-03-21-12.pdf

March 21, 2012: CMS Announces Graduate Nurse Education Demonstration CMS announced a new initiative to provide reimbursement to up to five eligible hospitals for the cost of providing clinical training to advanced practice registered nursing (APRN) students. More details, including a fact sheet and the funding opportunity document, are available at: http://innovation.cms.gov/initiatives/gne/

March 21, 2012: HHS OIG Releases Report on Medicaid Payments for Therapy Services The HHS Office of Inspector General (OIG) conducted a study of Medicaid payments for therapy services in excess of state limits. Although it identified a relatively low number of claims that were paid improperly, most of the errors were easily preventable. For the full report, see: http://oig.hhs.gov/oei/reports/oei-07-10-00370.asp

March 20, 2012: ASPE Releases Brief on Medicaid Participation Rates ASPE released the following issue brief on understanding participation rates in Medicaid and implications for the Affordable Care Act (ACA): http://aspe.hhs.gov/health/reports/2012/MedicaidTakeup/ib.shtmlMarch 19, 2012: HHS OIG Releases Assessment of Medicaid Integrity Contractors The HHS OIG conducted an early assessment of the efforts of Audit Medicaid Integrity Contracts to identify overpayments in Medicaid. The study found that 81% of audits either did not or are unlikely to identify overpayments. The full report, which includes recommendations to CMS, is available at: http://oig.hhs.gov/oei/reports/oei-05-10-00210.aspMarch 16, 2012: CMS Releases Actuarial Report on Financial Outlook for Medicaid CMS, Office of the Actuary released its annual report that looks at past financial trends and the projected outlook for Medicaid costs. The Actuarial Report on the Financial Outlook for Medicaid for 2011 includes projections of the program over the next ten years. The analysis includes estimated costs per enrollee by enrollment group (page 13 of the report) and historical and projected Medicaid enrollment and expenditures for total, federal, and state expenditures (page 19 of the report). The full report is available at: http://www.cms.gov/ActuarialStudies/Downloads/MedicaidReport2011.pdfMarch 16, 2012: CMS Releases Final Rule on Medicaid Eligibility Changes CMS released the final rule on Medicaid eligibility changes under the Affordable Care Act (ACA). The final rule sets standards for expanded access to health insurance coverage through Medicaid and Children’s Health Insurance (CHIP) programs for individuals under the age of 65 with incomes up to 133% of the federal poverty level. The final rule places greater reliance on data-based verification as opposed to documentation required from individuals; streamlines eligibility categories into four primary groups covering children, pregnant women, parents and the new adult group; simplifies income-based rules and systems for processing Medicaid and CHIP applications and renewals for most individuals; and promotes better coordination across Medicaid, CHIP, and the exchanges. It does not finalize the Federal Medical Assistance Percentage (FMAP) methodology for newly eligible individuals, and CMS is still conducting research and working with states on this issue. The final rule is available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/REG-03-16-12.pdf

March 16, 2012: CMS and CDC to Conduct Health Care Associated Infections (HAI) Prevention Program Scan CMS in collaboration with the Centers for Disease Control (CDC) will conduct a HAI Prevention Program Environmental Scan of state survey agency coordinators and state HAI coordinators. The randomly selected states to participate are Nebraska, Washington, Texas, Illinois, North Carolina, Colorado, and Massachusetts. For more information, go to: http://www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter12_22.pdf

March 15, 2012: CMCS Provides Medicaid and CHIP Updates The Center for Medicaid and CHIP Services (CMCS) released information to states on enforcement discretion regarding compliance with new HIPAA standards for electronic health transactions, approval of the first Balancing Incentive Program Grant Award, and Medicaid Emergency Psychiatric Demonstrations awards. The memorandum is available at: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-3-15-12.pdf

March 15, 2012: Medicaid and CHIP Payment and Access Commission (MACPAC) Releases Two Reports MACPAC released its March 2012 report to Congress on Medicaid and CHIP, which includes four recommendations to improve these programs, as well as a report on national findings related to access to health care and service use for children enrolled in Medicaid or CHIP. Both reports can be accessed at: http://www.macpac.gov/reports

March 15, 2012: CMS Announces New Initiative for Medicare-Medicaid Enrollees CMS announced a new Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents, which is designed to improve care for dual-eligible individuals living in nursing facilities. CMS issued a request for applications, with a June 14, 2012 deadline. Eligible organizations include physician practices, care management organizations, and other public and not-for-profit entities. Click here for more information: http://innovation.cms.gov/initiatives/rahnfr/March 13, 2012: CMS Announces Medicaid Emergency Psychiatric Demonstration Awards CMS announced that 11 states and the District of Columbia will participate in the Medicaid Emergency Psychiatric Demonstration established by the Affordable Care Act (ACA). Click here for more details: http://tinyurl.com/724wymeMarch 12, 2012: HHS Releases Final Rule on Insurance Exchanges HHS released final regulations to implement Insurance Exchanges under the ACA. The regulations spell out the standards for establishing and operating “one-stop” marketplaces, qualifications for health insurance plan participation, exchange health plan and subsidy eligibility determination for individuals, and criteria for small business eligibility and participation. Certain provisions of the final rule are being issued as interim final because HHS is seeking comments on the provisions. The final rule is available at: http://www.ofr.gov/OFRUpload/OFRData/2012-06125_PI.pdf

March 2, 2012: CMS Seeks Comment on Prescription Drug Information Collection Request CMS published a notice in the Federal Register related to the National Average Drug Acquisition Cost (NADAC) it is developing to provide states with a more accurate reference price to base reimbursement for prescription drugs. The information collection request is related to its nationwide survey of pharmacies. Click here for more details: http://www.gpo.gov/fdsys/pkg/FR-2012-03-02/pdf/2012-5020.pdf

March 2, 2012: CMS Seeks Comment on Information Request Related to Health Insurance Exchanges CMS published the following notice in the Federal Register regarding an upcoming Health Insurance Exchange funding announcement and information collection associated with these grants: http://www.gpo.gov/fdsys/pkg/FR-2012-03-02/pdf/2012-5011.pdf

February 24, 2012: HHS Publishes Medicaid Recovery Audit Contractors (RACs) Update HHS published a notice in the Federal Register announcing an increase to the maximum contingency fee that may be paid to RACs by state Medicaid programs: http://www.gpo.gov/fdsys/pkg/FR-2012-02-24/pdf/2012-4364.pdf February 24, 2012: HHS Releases Proposed Rules for Electronic Health Records (EHR)-Stage 2 HHS announced the next steps for providers using EHR technology and receiving incentive payments from Medicare and Medicaid by releasing two proposed rules. The first specifies the criteria that providers must meet to qualify for incentive payments and makes changes to Stage 1 criteria. The second identifies standards and criteria for the certification of EHR technology. The proposed rules and fact sheets are available at: http://www.hhs.gov/news/press/2012pres/02/20120224a.html

February 23, 2012: HHS Releases Annual Report on Pre-Existing Condition Insurance Plan (PCIP) Program The annual report includes state-by-state information on the PCIP program including the number of people enrolled through December 31, 2011, and the proportion of people enrolled by gender and age. Click here to access the report: http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf

February 22, 2012: CMCS Releases Information on Section 1115 Demonstrations, Other Updates The Center for Medicaid and CHIP Services (CMCS) released information on the final regulations that establish the review and approval process for Medicaid and CHIP Section 1115 demonstrations. The bulletin also includes information related to the State Innovation Waiver and Health Insurance Exchange Establishment Grants. For more information, see: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/CIB-02-22-12.pdf

February 22, 2012: CCIIO Extends Deadline for Exchange Establishment Grants The Center for Consumer Information and Insurance Oversight (CCIIO) publicly signaled its intention to extend the deadline for exchange establishment grants (both level one and level two) through the end of 2014. These extensions will afford more states considering or seeking to establish health insurance exchanges additional time to apply for funds. February 22, 2012: Supreme Court Sends California Medicaid Case on Provider Reimbursements Back to Ninth Circuit The U.S. Supreme Court in a 5-4 decision sent the case about whether private parties may pursue legal action under the Supremacy Clause back to the United States Court of Appeals for the Ninth Circuit. The case, Douglas v. Independent Living Center of Southern California (No. 09-958, consolidated), involved new California laws that reduced the reimbursement rates paid to Medicaid providers and beneficiaries. Those providers and beneficiaries argued that the California statutes violated federal Medicaid law and secured temporary injunctions blocking implementation. Before the Supreme Court heard the case last October, HHS in an administrative action held that the California statutes did not violate federal Medicaid law. The court’s opinion vacated the injunctions and remanded the cases back to the Ninth Circuit for the parties to argue the legality of the California laws subject now to the HHS administrative decision.

February 17, 2012: CMS Provides Early Retiree Reinsurance Program (ERRP) Update CMS released a document showing payments by state/sponsor as of January 19, 2012. According to CMS, the requests for reimbursement exceed the $5 billion appropriated for the program. CMS is holding in order of receipt those reimbursement requests which exceed the program’s appropriation, pending the availability of funds that may become available as a result of overpayment recoupment activities. More details are available at: http://cciio.cms.gov/resources/files/Files2/02172012/errp-posting_feb2012.pdf

February 22, 2012: CMS Releases Two Final ACA Rules CMS released a final rule to codify the requirements under the Affordable Care Act (ACA) to increase transparency of the Medicaid waiver development and approval processes at the state and federal levels. It requires new transparency measures to ensure public input in the development, review, and approval (or extension) of Medicaid and CHIP demonstrations under Section 1115 of the Social Security Act. More information is available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2012-04354.pdf

February 14, 2012: HHS Updates Prevention and Public Health Fund Data HHS updated information on ACA Prevention and Public Health Fund activities and awards by state: http://www.healthcare.gov/news/factsheets/2011/02/prevention02092011a.html February 13, 2012: HRSA Releases Proposed Rule for National Practitioner Data Bank The Health Resources and Services Administration (HRSA) published a proposed rule in the Federal Register to incorporate changes to the National Practitioner Data Bank included in ACA: http://www.gpo.gov/fdsys/pkg/FR-2012-02-15/pdf/2012-3014.pdfJanuary 31, 2012: New Report Estimates Medicaid Impact of Tax on Health Insurers A report by the Milliman, Inc. actuarial consulting firm analyzed a provision of ACA that will impose a new tax on health insurance companies to fund coverage expansions. The report states that the health insurer tax will cost the Medicaid program between $36.5 billion and $41.9 billion over 10 years. The full report can be accessed at: http://www.mhpa.org/_upload/MillimanReport.pdfJanuary 30, 2012: CMCS Provides Medicaid and CHIP Updates The Center for Medicaid and CHIP Services (CMCS) published an informational bulletin to provide states with details on three items: publication of the notice of proposed rulemaking that implements the Medicaid drug provisions of ACA, an Office of Inspector General (OIG) report on Medicaid hospital outlier payments, and implementation of the Medicaid National Correct Coding Initiative: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/CIB-1-30-12.pdf January 30, 2012: CMS Requests Information on Reinsurance Program CMS published a notice in the Federal Register to gain market information on entities that could administer a transitional reinsurance program. This will inform future requests for proposals. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2012-01-30/pdf/2012-1944.pdf

January 27, 2012: CMS Releases Proposed Rule for Medicaid Prescription Drugs CMS announced a proposal to implement the Medicaid prescription drug provisions in ACA. It includes the revised definition of Average Manufacturer Price (AMP) and other key aspects of Medicaid coverage, payment, and the drug rebate program. More details are available at: http://www.cms.gov/apps/media/press/release.asp?Counter=4251&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&sr January 25, 2012: HHS Provides Additional Information on Essential Health Benefit (EHB) Benchmark Plans The original guidance on EHBs allowed states to pick their benchmark package from among several possible options. To complement the guidance, HHS has provided an illustrative list of the largest three small group products by state. Click here for more details: http://cciio.cms.gov/resources/files/Files2/01272012/top_three_plans_by_enrollment_508_20120125.pdf January 23, 2012: Patient-Center Outcomes Research Institute (PCORI) Releases Draft Research Agenda and National Priorities PCORI, created by ACA, released for public comment a first draft of its national priorities for research and research agenda, which will be used to guide funding announcements for comparative clinical effectiveness research. More information can be found at: http://www.pcori.org/2012/priorities-agenda/January 23, 2012: Agencies Release Additional Guidance on Cost Allocation Exception In an effort to clarify previous guidance on cost allocation, HHS and the Department of Agriculture (USDA) issued a letter to states to provide further information on the time-limited, specific exception to OMB Circular A-87 regarding state eligibility determination systems. Specifically, the guidance provides clarifications and examples of what would qualify as a shared service. To view the guidance, go to: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD-01-23-12.pdf

For more details on the original guidance, see Issue Brief 11-31, HHS, USDA Announce Cost Allocation Flexibility

January 20, 2012: CMS Releases Information on Affordable Care Act (ACA) Program Integrity Provisions CMS released a bulletin to states on section 6501 of ACA regarding the termination of provider participation under Medicaid if such an individual or entity is terminated under Medicare or other state plan. To view the bulletin, see: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/CIB-01-20-12.pdf

January 19, 2012: HHS OIG Releases Baseline Survey on National and State Background Checks ACA required the HHS Office of Inspector General (OIG) to submit a report to Congress evaluating the National and State Background Checks on Direct Patient Access Employees of Long-Term-Care Facilities and Providers program. The results of OIG’s survey of long-term care provider administrators, which was conducted to collect baseline data on current practices in order to assess the program, is available at: http://oig.hhs.gov/oei/reports/oei-07-10-00421.asp January 18, 2012: White House Releases Progress Report on Health Care Reform Implementation The White House released the following report that details state actions related to health care reform, including state details on insurance exchange actions and funding: http://www.whitehouse.gov/sites/default/files/01-18-12_exchange_report.pdf

January 18, 2012: CBO Issues Report on Medicare Demonstration Programs The Congressional Budget Office (CBO) released an issue brief that examined demonstration projects for disease management, care coordination, and value-payment systems and assessed their respective impact on cost reductions in Medicare. According to the report, most demonstrations produced little or no savings for Medicare; however, the results for value-based payment systems demonstrations were mixed. To read the full report, see: http://www.cbo.gov/ftpdocs/126xx/doc12663/01-18-12-MedicareDemoBrief.pdf

January 3, 2012: CMS Selects Participants for New Innovation Advisors Program CMS announced that it has selected 73 individuals from 27 states and the District of Columbia for its Innovation Advisors Program. These advisors will work with CMS to test new models of care delivery in their own organizations and communities. More details can be found at: http://tinyurl.com/7bv9uez

December 30, 2011: CMS Releases Guidance on Affordable Care Act (ACA) Program Integrity Provisions CMS issued guidance to states on the expansion of the Recovery Audit Contractor (RAC) program to Medicaid:. The guidance discusses an enhanced contingency fee and provides links to frequently asked questions: http://www.medicaid.gov/Federal-Policy-Guidance/CIB-12-30-2011.pdfDecember 23, 2011: CMCS Provides Guidance on Medicaid/Children’s Health Insurance Program (CHIP) Provider Screening and Enrollment The Center for Medicaid and CHIP Services (CMCS) released an information bulletin that provides guidance to states on section 6401 of ACA, which details provider screening and enrollment requirements under Medicare, Medicaid, and CHIP. The guidance includes a state plan information and frequently asked questions. Click here for more information: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/CIB-12-23-11.pdf

December 22, 2011: ACF Requests Approval of Mother and Infant Home Visiting Program Evaluation (MIHOPE) Site Recruitment The Administration for Children and Families (ACF) seeks emergency approval of its site recruitment efforts, which will request additional from states on their home visiting programs. This evaluation is mandated by ACA and will assess the effectiveness of the new home visiting program. More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-12-22/pdf/2011-32824.pdf

December 20, 2011 CMS Announces New Demonstration to Provide At-Home Care for Medicare Patients CMS released the funding opportunity document for the new Independence at Home Demonstration, authorized by section 3024 of ACA, which will test the effectiveness of providing primary care services in a home setting on improving care for Medicare beneficiaries with multiple chronic conditions. Applications are due February 6, 2012. For more information, click here: http://tinyurl.com/83cqqxt

December 19, 2011: CMS Publishes Proposed Rule on Transparency Reports for Manufacturers CMS published a proposed rule in the Federal Register that would require applicable manufacturers of drugs, devises, biological, or medical supplies covered by Medicare, Medicaid, or CHIP to report annually certain payments or transfers of value provided to physicians or teaching hospitals as well as certain physician ownership or investment interests. The proposal can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-12-19/pdf/2011-32244.pdf

December 19, 2011: HHS Announces 32 Pioneer Accountable Care Organizations (ACOs) HHS announced those organizations that will participate in the ACA pioneer ACOs initiative, which will test the effectiveness of several innovative payment models and how they can help organizations provide better care and reduce Medicare costs. More information is available at: http://www.hhs.gov/news/press/2011pres/12/20111219a.html

December 16, 2011: CMS Updates Guidance on Use of Civil Money Penalty (CMP) Funds byStates ACA included provisions regarding the collection and uses of CMPs imposed by CMS when nursing homes do not meet requirements for long term care facilities. CMS released updated guidance on the specifics around the approval process. The full guidance is available at: http://www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter12_13.pdfDecember 16, 2011: CMS Updates Guidance on Use of Civil Money Penalty (CMP) Funds byStates ACA included provisions regarding the collection and uses of CMPs imposed by CMS)when nursing homes do not meet requirements for long term care facilities. CMS released updated guidance on the specifics around the approval process. The full guidance is available at: http://www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter12_13.pdfDecember 14, 2011: HHS Announces Awards for Hospital Engagement Networks HHS announced $218 million in ACA funds for 26 state, regional, national, and hospital system organizations. As part of the Partnership for Patients initiative, these Hospital Engagement Networks will help providers identify and share ways to reduce health care-acquired conditions and improve care. More information is available at: http://www.hhs.gov/news/press/2011pres/12/20111214j.html

December 13, 2011: CMS Publishes Notice on Early Retiree Reinsurance Program (ERRP) CMS published a notice in the Federal Register announcing that based on the projected availability of funding under EERP, it will deny reimbursement requests that include claims incurred after December 31, 2011. Click here to view the notice: http://www.gpo.gov/fdsys/pkg/FR-2011-12-13/pdf/2011-31920.pdfDecember 12, 2011: ACF and HRSA Seek Comments on Home Visiting Survey The Administration for Children and Families (ACF) and the Health Resources Services Administration (HRSA) have launched a national evaluation of the Maternal, Infant and Early Childhood Home Visiting program, as mandated by the Affordable Care Act (ACA). They published the following notice in the Federal Register, which describes the evaluation process and seeks comment the baseline survey data collection process: http://www.gpo.gov/fdsys/pkg/FR-2011-12-12/pdf/2011-31597.pdf

December 8, 2011: HRSA Awards $14 Million for School-Based Health Centers HRSA awarded $14 million in ACA funds to 45 school-based health centers to establish new sites or upgrade their current facilities. Click here for more information, including a list of grantees: http://www.hhs.gov/news/press/2011pres/12/20111208a.html

December 7, 2011: CMS Releases Final Rule on Medicare Data for Performance Measurement CMS published the following final rule in the Federal Register regarding the release and use of Medicare claims data for qualified entities to measure the performance of providers and services and supplies: http://www.gpo.gov/fdsys/pkg/FR-2011-12-07/pdf/2011-31232.pdf

December 5, 2011: CMS Launches Technical Assistance Center for the Balancing Incentive Program CMS, in partnership with Mission Analytics Group, announced the launch of the Technical Assistance Center for the Balancing Incentive Program. This center provides resources for states such as the program application, the implementation manual, a sample work plan, frequently asked questions, and webinars. Click here for more information: http://www.balancingincentiveprogram.org/December 2, 2011: CMS Releases Final Medical Loss Ratio (MLR) Rule CMS issued a final regulation to ensure that health insurance companies spend at least 80% of health insurance premiums on medical care. Insurance companies that fail to meet the new standard will be required to provide a rebate to consumers. The MLR rule took effect on January 1, 2011, but this final rule makes modifications and provides certainty to how the MLR is calculated. More information is available at: http://cciio.cms.gov/resources/factsheets/mlrfinalrule.html

November 2011: CMS Announces Project to Calculate FMAP for "Newly Eligible" Population CMS announced the selection of 10 states that have agreed to participate in a research project targeted at developing methodologies for calculation of the FMAP for the "newly eligible" population of Medicaid enrollees as required by the ACA. The project will also include efforts to identify strategies for conversion to Modified Adjusted Gross Income (MAGI) when the ACA eligibility changes take effect on January 1, 2014. The states that will be participating in this study are: Arizona, California, Indiana, Nebraska, New Hampshire, New York, Oregon, Tennessee, Virginia, and West Virginia. The purpose of the project is to develop these methodologies, assess their feasibility, and create technical assistance materials that will be made available for the benefit of all states. The project will be led by the RAND Corporation in collaboration with the State Health Access Data Assistance Center (SHADAC) and the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE). November 29, 2011: HHS Awards $220 Million in Health Insurance Exchange Establishment Grants Thirteen states received $220 million to implement health insurance exchanges. These awards are in addition to the 16 states and the District of Columbia that received funds earlier this year. The Department of Health and Human Services (HHS) will accept applications until June 29, 2012. HHS also released frequently asked questions to help states set up their exchanges. More details can be found at: http://www.hhs.gov/news/press/2011pres/11/20111129a.html

November 2011: MACPAC Releases Overview of Medicaid Fee for Service (FFS) Process The Medicaid and CHIP Payment and Access Commission (MACPAC), funded under the Affordable Care Act (ACA), released the following paper on the Medicaid FFS provider payment process: https://docs.google.com/viewer?a=v&pid=sites&srcid=bWFjcGFjLmdvdnxtYWNwYWN8Z3g6MWUzMWQ5ZDJhZWYyODk2ZANovember 21, 2011: CMS Guidance on Core Area 10 for Exchange Establishment Grants CMS issued guidance to states on the implementation of Exchange Establishment Grants as it relates to participation in Core Area 10, which concerns assistance to individuals and small business, coverage appeals, and complaints. CMS’s guidance can be accessed here: http://cciio.cms.gov/resources/files/Files%202/11072011/cap_exchange_funding_memo.pdf.pdfNovember 14, 2011: CMS Announces Health Care Innovation Challenge CMS Innovation Center announced a $1 billion program that will provide grants to implement new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid, and CHIP, particularly those with the highest health care needs. Examples of the types of organizations expected to apply are: provider groups, health systems, payers and other private sector organizations, faith-based organizations, local governments, and public-private partnerships and for-profit organizations. More information is available at: http://innovations.cms.gov/initiatives/innovation-challenge/index.html

November 14, 2011: Additional States Launch Medicaid EHR Incentive Programs Six states (Arkansas, Delaware, Montana, New Jersey, New York, and North Dakota) launched their Medicaid Electronic Health Record (EHR) Incentive Program. Thirty-nine states have launched their programs and 23 states have issued incentive payments to Medicaid eligible professionals and eligible hospitals who have adopted, implemented, or upgraded certified EHR technology. More details are available at: https://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp#TopOfPageNovember 14, 2011: Supreme Court to Review Health Care Reform The U.S. Supreme Court announced that it would review the constitutionality of the Affordable Care Act (ACA) this spring during an historic five and one-half hours of arguments. The court will hear arguments on the mandate requirement, severability, limits on challenges by public and private parties under the Anti-Injunction Act (26 USC 7421(a)) to the mandate requirement, and whether the act's expansion of Medicaid oversteps the Spending Clause. The questions come from these cases accepted for review: National Federation of Independent Business v. Sebelius (No. 11-393); Florida, et al. v. HHS (No. 11-400); and, HHS, et al. v. Florida, et al. (No. 11-398).

November 2, 2011: CMCS Provides Medicaid and CHIP Updates The Center for Medicaid and CHIP Services (CMCS) released the following bulletin to states to provide an update of recent actions, including the annual report on the quality of care for children in Medicaid and CHIP, the creation of the Innovation Advisors Program, and the issuance of two final rules on Accountable Care Organizations in the Medicare fee-for-service system: http://www.cms.gov/CMCSBulletins/downloads/CIB-11-02-11.pdf

November 7, 2011: HRSA Requests Comments on Proposed Eligibility Criteria for Health Professions Education The Health Resources and Services Administration (HRSA) published a notice in the Federal Register to request comments on its proposed eligibility criteria for the Centers of Excellence program in health professions education for under-represented minority individuals as amended by the Affordable Care Act (ACA). More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-11-07/pdf/2011-28670.pdf

October 31, 2011: CMCS Provides Guidance to States on Section 3309 of ACA CMCS issued the following informational bulletin to states on section 3309 of the ACA, which eliminates Part D cost-sharing for full benefit dual eligible individuals receiving home and community-based services: http://www.cms.gov/CMCSBulletins/downloads/cib-10-31-11.pdf

October 24, 2011: CMS Announces Selections for Advanced Primary Care Practice Demonstration CMS announced that 500 Federally Qualified Health Centers (FQHC) in 44 states have been selected for the FQHC Advanced Primary Care Practice demonstration project. The community health centers will receive approximately $42 million over three years to improve the coordination and quality of health care. More information on the program, including a listing of participants, can be found at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/fqhc/

October 20, 2011: HHS Announces Two Accountable Care Organizations (ACO) Initiatives HHS announced the final rule for the Medicare Shared Savings Program and a solicitation for the Advance Payment Model. Additional details can be found at: http://www.hhs.gov/news/press/2011pres/10/20111020a.html

October 17, 2011: CMS Accepting Application for New Innovation Advisors Program CMS announced that it is seeking application for a new Affordable Care Act (ACA) program to help health care professions expand their skills and knowledge to improve patient care and reduce costs in their communities. Applications are due on November 15, 2011. More information is available at: http://innovations.cms.gov/innovation-advisors-program/

October 14, 2011: HHS Suspends Community Living Assistance Services and Supports (CLASS) Act The Department of Health and Human Services (HHS) informed Congress that it is suspending implementation of the CLASS Act based on the findings by the department actuaries that the program is not financially sustainable. The CLASS Act, included in ACA, was a voluntary, national insurance program to provide assistance to workers to help pay for long term care and supportive services. Click here for additional information: http://www.hhs.gov/secretary/letter10142011.html

October 2011: ACF Releases Draft of Social Security Act Related to Title IV-B and Title IV-E The Administration for Children and Families (ACF) released the following draft the of Social Security Act, which reflects changes from the ACA and the Fostering Connections to Success and Increasing Adoptions Act: http://www.acf.hhs.gov/programs/cb/new_site.htm

October 6, 2011: CMS Releases State Information on ACA Preventive Services, Prescription Drugs CMS released state-by-state information on utilization of preventive services under ACA as well as the prescription drug coverage gap discount program. Click here to view the information: http://www.hhs.gov/news/press/2011pres/10/20111006b.html

October 3, 2011: CMS Announces Comprehensive Primary Care Initiative CMS released a solicitation for the Comprehensive Primary Care initiative, a multipayer model designed to improve primary care. Under the new initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their patients. The initiative will begin as a demonstration project available in five to seven health care markets across the country. Public and private health care payers (including states) interested in applying must submit a Letter of Intent by November 15, 2011. Additional details are available at: http://www.gpo.gov/fdsys/pkg/FR-2011-10-03/pdf/2011-25356.pdf and http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/cpci/

September 30, 2011: CDC Awards $9 Million for Comprehensive Workplace Health Programs The Centers for Disease Control and Prevention (CDC) announced $9 million in awards, funded by ACA, to help workplaces support health lifestyles and reduce risk factors for chronic diseases: http://www.cdc.gov/media/releases/2011/p0930_improve_healthcare.html September 30, 2011: CMS Releases Guidance on Use of Civil Money Penalty (CMP) Funds by States CMS released the following memorandum to state survey agency directors on section 6111 of ACA, which amends the Social Security Act to incorporate specific provisions pertaining to the imposition and collection of CMPs when nursing homes do not meet Medicare and Medicaid requirements for long-term care facilities: http://www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter11_42.pdf September 29, 2011: CDC Announces Childhood Obesity Demonstration Project CDC announced $25 million in ACA funding for a four-year Childhood Obesity Demonstration Project, which will target children ages 2-12 covered by the Children’s Health Insurance Program (CHIP). For more information, including a list of grantees, click here: http://www.cdc.gov/media/releases/2011/p0929_combat_child_obesity.html September 29, 2011: HRSA Announces Quality Improvement and Patient-Centered Medical Home Development Funds HRSA announced FY 2011 grant awards for the Quality Improvement and Patient-Centered Medical Home Development, funded by the ACA Prevention and Public Health Fund, to provide upfront assistance to existing health centers as they try to achieve recognition as a patient-centered medical home: http://www.hhs.gov/news/press/2011pres/09/20110929b.html

September 29, 2011: SAMHSA Releases Primary and Behavioral Health Integration Awards The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $15 million in grants, funded by the ACA Prevention and Public Health Fund, to support and promote better primary care and behavioral health services for individuals with mental and substance abuse disorders: http://www.hhs.gov/news/press/2011pres/09/20110929b.html September 28, 2011: CMCS Releases Guidance for State Consumer-Oriented Websites The Center for Medicaid, CHIP, and Survey & Certification (CMCS) released the following bulletin to provide information to states on funding availability and implementation of section 6103(d)(2) of ACA, which requires states to maintain a consumer-oriented website containing information on nursing facilities: http://www.cms.gov/CMCSBulletins/downloads/CIB-9-28-11.pdf September 27, 2011: CDC Announces Preparedness and Emergency Response Learning Centers (PERLC) Awards CDC announced its intent to award ACA Prevention and Public Health funding to seven existing PERLCs. The purpose of this program is to develop, deliver, and evaluate core competency-based training and education that target the public health workforce and address the public health preparedness and response needs of state, local, and tribal governments. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2011-09-27/pdf/2011-24750.pdf

September 22, 2011: HHS Awards $224 Million for Home Visiting Programs HHS announced $224 million in awards under ACA’s Maternal, Infant, and Early Childhood Home Visiting Program. Of that amount, $124 million is for formula grants and $100 million for competitive grants. More information, including a list of grantees, can be found at: http://www.hhs.gov/news/press/2011pres/09/20110922b.html

September 20, 2011: CMCS Releases Medicaid/CHIP Updates CMCS issued an informational bulletin which includes updates on the Balancing Incentive Program, the release of a request for information regarding the Basic Health Program authorized in ACA, and the issuance of proposed rules that would give patients direct access to their own laboratory test result reports. Click here for more information: http://www.cms.gov/CMCSBulletins/downloads/cib-9-20-11.pdfSeptember 20, 2011: HHS Awards $109 Million for Health Insurance Rate Review Grants HHS announced the award of $109 million to 28 states and the District of Columbia for a second round of rate review grants. It also released a report detailing how states are using funds. Click here for additional details: http://www.hhs.gov/news/press/2011pres/09/20110920a.html September 19, 2011: HHS Releases Information Regarding Partnership Options on Insurance Exchanges HHS released additional information regarding opportunities for states to partner with the federal government to operate health insurance exchanges as required by the Affordable Care Act (ACA). Under the proposed partnership model, states may choose to perform health plan management, consumer assistance, or both. If choosing to perform plan management, the state would conduct plan analysis, monitoring, and data collection while the federal government would assist with consumer complaints and enrollment reconciliation. The consumer assistance model would allow the state to oversee in-person consumer assistance, manage the Navigator program to help individuals sign up for insurance, and conduct outreach and education. The federal government would assist with functions that can be centralized such as call center operations and website management. HHS is seeking feedback on these proposals as states submit comments to the proposed rule on health exchange establishment for which the comment period closes on September 28, 2011. More information is available at: http://www.healthcare.gov/news/factsheets/2011/09/exchanges09192011a.html September 16, 2011: CMS Releases Final Medicaid Rule on Recovery Audit Contractors (RACs) The Centers for Medicare & Medicaid Services (CMS) issued the final rule to implement section 6411 of ACA, which directed states to establish programs by December 31, 2010, that contract with Medicaid RACs to review claims submitted by providers to identify overpayments and underpayments. The final rule provides states with guidance relating to funding and the payment methodology for state payments to Medicaid RACs. HHS projects the RAC program will save $2.1 billion over five years, $900 million of which will be savings to states. The rule is effective on January 1, 2012. More information is available at: http://www.gpo.gov/fdsys/pkg/FR-2011-09-16/pdf/2011-23695.pdf

September 15, 2011: HHS Awards Health Center Planning Grants HHS announced $10 million in ACA funds to help organization become community health centers. More details, including a list of organizations by state, can be found at: http://www.hhs.gov/news/press/2011pres/09/20110915e.html September 14, 2011: CMS Seeks Comments on State Flexibility to Establish Basic Health Program CMS published a notice in the Federal Register to request information on section 1331 of ACA, which provides states with the option to establish a Basic Health Program. Comments must be received by October 31, 2011. More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-09-14/pdf/2011-23388.pdfSeptember 2, 2011: HHS Announces Almost $12 Million to Implement HIT in Rural Areas HHS announced that 40 grantees in rural areas will receive funds under the Rural Health Information Technology program to support their adoption of Health Information Technology (HIT) and certified Electronic Health Records (EHR). A list of grantees is available at: http://www.hhs.gov/news/press/2011pres/09/20110902a.html September 1, 2011: HHS Provides Update of State Insurance Rate Review Programs HHS released the following fact sheet that outlines state achievements with their rate review programs as well as how states are using rate review grant funds: http://www.healthcare.gov/news/factsheets/ratereview09012011b.html

August 31, 2011: HHS Awards $40 Million for Public Health Infrastructure and Training HHS announced FY 2011 awards for two programs: Strengthening Public Health Infrastructure for Improved Health Outcomes grant program and the Public Health Training Center Program. These programs receive funding from the Prevention and Public Health Fund included in the Affordable Care Act (ACA). For more information and to view a list of grantees by state, click here: http://www.hhs.gov/news/press/2011pres/08/20110831a.html

August 31, 2011: CMS Releases Information Bulletin on Medicaid/Children's Health Insurance Program (CHIP) CMS issued the following bulletin to update states on a number of issues, including recently released proposed rules, letters regarding ACA maintenance-of-effort provisions and cost allocation, and the availability of grant funds: http://www.cms.gov/CMCSBulletins/downloads/cib-8-31-11.pdf

August 31, 2011: Republican Governors Public Policy Committee (RGPPC) Releases Medicaid Policy Options The RGPPC released a report, “A New Medicaid: A Flexible, Innovative and Accountable Future,” that summarizes policy ideas from the RGPPC task force and includes 31 proposals that focus on greater flexibility for states: http://energycommerce.house.gov/news/PRArticle.aspx?NewsID=8888

August 2011: KFF Brief Summarizes States' Preliminary Proposals for Dual Eligibles The Kaiser Family Foundation (KFF) released a brief that summarizes 15 states’ preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the Center for Medicare and Medicaid Innovation under ACA, focus on new service delivery and payment models that integrate care for dual eligibles. The brief is available at: http://www.kff.org/medicaid/8215.cfmAugust 25, 2011: HHS Awards $137 Million to Strengthen Prevention and Public Health HHS awarded $137 million to state and local governments and territories to provide tobacco-cessation services, strengthen public health laboratory and immunization services, prevent health care-associated infections, and provide comprehensive substance abuse prevention and treatment. Most of these awards are funded through the Prevention and Public Health Fund created by ACA. For more information, including a list of grantees, click here: http://www.hhs.gov/news/press/2011pres/08/20110825a.html

July 27, 2011 GAO Releases Report on the Pre-Existing Condition Insurance Plan (PCIP) Program The Government Accountability Office (GAO) released the following report on the PCIP program that examines 1) program features, 2) trends in enrollment and spending, including administrative costs, and 3) federal oversight activities: http://www.gao.gov/new.items/d11662.pdf

August 23, 2011: HHS Announces New Bundled Payment Initiative HHS announced the Bundled Payments for Care Improvement Initiative, and invited providers to apply to help test and develop four different models of bundling payments. This initiative is being launched by the Center for Medicare and Medicaid Innovation. More details can be found at: http://www.hhs.gov/news/press/2011pres/08/20110823a.html

August 16, 2011: HHS OIG Releases Report on Prescription Drug Rebates HHS Office of Inspector General (OIG) issued a report that found Medicaid’s net unit drug costs (pharmacy reimbursement minus rebates) were much lower than those under Medicare Part D because of substantially higher Medicaid rebates for brand-name drugs. The report was required by section 3313(b) of the Affordable Care Act (ACA). More information is available at: http://oig.hhs.gov/oei/reports/oei-03-10-00320.pdf

August 15, 2011: CDC Awards $49 Million to State and Local Health Departments The Centers for Disease Control and Prevention (CDC) provided $49 million in grants, funded primarily by the ACA Prevention and Public Health Fund, to state and local health departments to strengthen their capacity to perform epidemiology and laboratory work, detect and prevent health care-associated infections, and support immunization programs. Additional details, including awards by state, are available at: http://www.hhs.gov/news/press/2011pres/08/20110815a.html

August 12, 2011: HHS Awards Additional Exchange Establishment Grants HHS awarded more than $185 million in Exchange Establishment grants to 13 states and the District of Columbia. This is in addition to the grants awarded in May 2011. States can apply for funds on a rolling basis, with the next deadline September 30, 2011. For a listing of grants by state, including a summary of funded projects, go to: http://www.healthcare.gov/news/factsheets/exchanges05232011a.html

August 12, 2011: HHS and Treasury Release Proposed Rules on Health Exchanges HHS and Treasury issued three proposed rules that cover exchange eligibility and employer standards, the health insurance premium tax credit, and Medicaid eligibility. The Medicaid eligibility proposed rule discusses how the exchange will interact with Medicaid and CHIP. It also provides additional details on the increased Federal Medical Assistance Percentage (FMAP) rates for the Medicaid expansion as well as three proposed methodologies for states to use to apply the appropriate FMAP for expenditures in accordance with section 2001 of ACA. More information, including a letter to governors, is available at: http://www.hhs.gov/news/press/2011pres/08/20110812a.html

August 10, 2011: HHS and Agriculture Announce Cost Allocation Waiver for Implementation of Eligibility Determination Systems The federal government is providing a time-limited, specific exception to the cost allocation requirements in OMB Circular A-87 to allow human service programs to benefit from investments in state eligibility systems being made by health exchanges, Medicaid, and CHIP. This exception allows programs, such as TANF, the Child Care Development Fund (CCDF), and the Supplemental Nutrition Assistance Program (SNAP) to utilize these systems without having to share in the common system development costs, as long as those costs would have been incurred anyway. The exception will expire on December 31, 2015. More details are available at: http://www.acf.hhs.gov/programs/cse/pol/DCL/2011/dcl-11-13a.pdf

August 9, 2011: HHS Awards $28.8 Million to Community Health Centers HHS provided $28.8 million in ACA funds to 67 community health centers to help establish new health service delivery sites. For more information, including a list of a grants by state, click here: http://www.hhs.gov/news/press/2011pres/08/20110809a.html

August 5, 2011: CMS Provides Additional Guidance on MOE Provisions The Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director letter to provide states with additional information on the maintenance-of-effort (MOE) provisions included in ACA as related to institutional care and home and community-based services as well as procedures to strengthen program integrity. The guidance can be accessed at: https://www.cms.gov/smdl/downloads/SMD11-009.pdf August 4, 2011: CMS Announces Medicaid Emergency Psychiatric Demonstration CMS announced a new demonstration designed to provide states with more flexibility and resources to care for Medicaid beneficiaries with mental illnesses. This demonstration provides up to $75 million in funding to states over three years, as authorized by section 2707 of ACA, to help care for Medicaid patients (ages 21 through 64) with psychiatric emergencies in private inpatient psychiatric facilities with 17 or more beds, also known as institutions for mental diseases (IMDs). The demonstration is being administered by the Center for Medicare and Medicaid Innovation. For more details on the demonstration and application process, click here: http://tinyurl.com/3f7q2jl

August 1, 2011: SAMHSA Awards $6 Million for Campus Suicide-Prevention Efforts The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $6.2 million in grants to 21 colleges and universities to assist in their efforts to prevent suicide and enhance mental health services. Part of the awards are funded through the ACA Prevention and Public Health Fund. To view grant recipients and their annual awards, go to: http://www.samhsa.gov/newsroom/advisories/1108013300.aspx

July 2011: GAO Issues Report on State Practices of Overseeing Premium Rates The Government Accountability Office (GAO) released the following study that found oversight of health insurance rates varied across states in 2010 with respect to the timing of rate filing reviews, the information considered in the reviews, and the opportunities for consumer involvement in rate reviews: http://www.gao.gov/new.items/d11701.pdf

July 2011: AOA Publishes ACA News The Administration on Aging (AOA) published its monthly newsletter on ACA, which includes recent federal guidance, state and local resources and activities, and a new care transitions toolkit. Click here to view the July issue: http://www.aoa.gov/aoaroot/Aging_Statistics/docs/ACA_Enews_0711.pdfAugust 1, 2011: HHS Releases New Guidelines on Women’s Preventative Care HHS adopted the recent guidelines developed by the Institutes of Medicine (IOM), which require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance, or a deductible. To read the full announcement, click here: http://www.hhs.gov/news/press/2011pres/08/20110801b.html

July 20, 2011: HHS Issues Proposed Rule on Consumer Operated and Oriented Plan (CO-OP) Program HHS published a proposed rule in the Federal Register on the CO-OP program, which provides loans to foster the creation of consumer-governed, private, non-profit, health insurance issuers to offer qualified health plans in the health care exchanges. The proposal is available at: http://www.gpo.gov/fdsys/pkg/FR-2011-07-20/pdf/2011-18342.pdf

More information on the CO-OP program is available at: http://tinyurl.com/3meyyhbJuly 15, 2011: HHS Updates State Enrollment Data for Pre-Existing Condition Insurance Plan (PCIP) HHS updated its chart that shows the number of people enrolled in the PCIP program by state as of May 31, 2011: http://www.healthcare.gov/news/factsheets/pcip07152011a.htmlJuly 14, 2011: HHS Awards Funds to School-Based Health Center Programs HHS awarded $95 million in funds, appropriated in ACA, to 278 school-based health center programs to address capital needs. For more information on the program and a list of grantees by state, click: http://www.hhs.gov/news/press/2011pres/07/20110714a.html July 14, 2011: CDC Announces Awards for Tracking Networks The Centers for Disease Control and Prevention (CDC) published a notice in the Federal Register announcing its intent to award ACA funds to seven states to develop and implement environmental public health tracking programs: http://www.gpo.gov/fdsys/pkg/FR-2011-07-14/pdf/2011-17661.pdf

July 13, 2011: CMS Releases Information Bulletin on Medicaid and CHIP Updates The latest Centers for Medicare & Medicaid Services (CMS) information bulletin highlights the following topics of interest to states: new initiative for Medicare-Medicaid enrollees, proposed regulations regarding health insurance exchanges, home health services, Paperwork Reduction Action package for Medicaid and CHIP, National Background Check Program conference, inclusion of training costs in rate development, and pharmacy pricing survey. The bulletin can be accessed at: http://www.cms.gov/CMCSBulletins/downloads/CIB-7-13-11.pdf July 12, 2011: CMS Publishes Proposed Rule on Medicaid Home Health CMS published a proposed rule in the Federal Register that would revise the Medicaid home health service definition as required by section 6407 of ACA to add a requirement that physicians document the face-to-face encounter with a Medicaid-eligible individual within certain timeframes. To view the proposal, including details on submitting comments, click here: http://www.gpo.gov/fdsys/pkg/FR-2011-07-12/pdf/2011-16937.pdfJuly 11, 2011: HHS Releases Proposed Rules on Health Insurance Exchanges HHS released guidance and minimum standards to assist states with establishing health insurance exchanges. The guidance covers two key areas: 1) setting standards for establishing exchanges, setting up a Small Business Health Options Program (SHOP), performing basic functions of an exchange, and certifying health plans for participating in the exchange, and 2) ensuring premium stability for plans and enrollees in the exchange. More details, including links to the regulations and instructions for submitting comments, can be found at: http://www.healthcare.gov/law/provisions/exchanges/index.html

July 8, 2011: CMS Announces New Financial Models to Support State Efforts to Integrate Care of Dual Eligibles CMS released guidance outlining two models for states pursuing integration of primary, acute, behavioral health, and long-term services for dual eligibles. Specifically, CMS is offering streamlined approaches for states interested in testing these models and technical assistance to support necessary planning activities. To view the guidance, go to: http://www.cms.gov/smdl/downloads/Financial_Models_Supporting_Integrated_Care_SMD.pdf

In addition, CMS announced a forthcoming initiative to help states improve the quality of care for nursing facility residents and is establishing a technical assistance resource center to better coordinate care for high-need, high-cost beneficiaries. More information is available at: http://www.hhs.gov/news/press/2011pres/07/20110708a.html

June 30, 2011: HHS Announces Administrative Simplification Rules HHS announced an interim final rule that implements section 1104 of the Affordable Care Act (ACA) and puts in place operating rules for two electronic health transactions. This is the first in a series of steps to streamline and simplify the health care system. Click here for more information: http://www.hhs.gov/news/press/2011pres/06/20110630a.html June 29, 2011: Court Upholds Requirement for the Individual Mandate in ACA A three-judge panel from the United States Court of Appeals for the Sixth Circuit ruled that it was constitutional for Congress to require that individuals buy health insurance. The ruling by the Sixth Circuit is expected to be followed soon by rulings in the Fourth Circuit and the Eleventh Circuit. The Supreme Court is expected to take up this issue perhaps as early as this fall. More information is available at: https://www.documentcloud.org/documents/212442-court-of-appeals-health-care-law-opinion.htmlJune 24, 2011 CMS Releases Guidance on New Medicaid Tobacco-Cessation Services CMS provided the following guidance to states on implementation of section 4107 of the ACA, which provides Medicaid coverage of comprehensive tobacco cessation services for pregnant women without cost sharing: http://www.cms.gov/smdl/downloads/SMD11-007.pdf

June 23, 2011: HHS Announces $10 Million for Workplace Health Programs HHS announced a $10 million funding opportunity, available from ACA’s Prevention and Public Health Fund, for an organization to establish and evaluate comprehensive workplace health promotion programs. The application deadline is August 8, 2011. For more details, click here: http://www.hhs.gov/news/press/2011pres/06/20110623a.html

June 22, 2011: HHS Announces $500 Million in Partnerships for Patient Funding HHS announced that up to $500 million will be available to help hospitals and health care providers improve care and reduce preventable injuries from health care acquired conditions. More information on this federal contract opportunity can be found at: http://www.hhs.gov/news/press/2011pres/06/20110622a.html

June 22, 2011: Federal Departments Amend and Provide Guidance on External Review Processes The departments of HHS, Labor, and Treasury released amendments to the July 23, 2010 Interim Final Rule regarding claims and appeals and the external review processes for group health plans and health insurance issuers offering coverage in the group and individual markets. As part of these changes, the transition period for state external review processes is extended to January 1, 2012. Click here for more information: http://cciio.cms.gov/resources/files/working_with_states_to_protect_consumers_06222011.html

June 17, 2011: CMS Issues Guidance on Reporting Reasonable Suspicion of Crime in a Long-Term Care Facility CMS issued the following letter to state survey agency directors regarding section 6703 of the Affordable Care Act (ACA), which requires specific individuals in long-term care facilities to report any reasonable suspicion of crimes committed against a resident of that facility: http://www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter11_30.pdf

June 17, 2011 CMS Releases New Annual Limits Waiver Guidance CMS issued guidance to allow limited benefit or “mini-med” plans to apply for or renew a temporary waiver from ACA’s restrictions on annual benefit limits through 2013. CMS announced that, after September 22, 2011, no new applications or requests for extensions will be considered. More details are available at: http://cciio.cms.gov/resources/files/approved_applications_for_waiver.html

In addition, the Government Accountability Office (GAO) issued the following report that reviewed the waivers granted by HHS as of April 2011, focusing on the number of applications, how may were approved or denied, and reasons for approval and denials: http://www.gao.gov/products/GAO-11-725RJune 10, 2011: HHS Updates Pre-Existing Insurance Plan (PCIP) Enrollment Data HHS released the following chart that details when each state began providing benefits to people accepted into the PCIP program and the number of people enrolled in the program by state as of April 30, 2011: http://www.healthcare.gov/news/factsheets/pcip06102011a.htmlJune 8, 2011: CMS Issues Proposed Rule on Medicare Data for Performance Measurement CMS proposes to implement new statutory requirements, included in section 10332 of the Affordable Care Act (ACA), regarding the release and use of Medicare claims data to measure the performance of providers and suppliers. Comments must be received by August 8, 2011. For more information, click here: http://www.gpo.gov/fdsys/pkg/FR-2011-06-08/pdf/2011-14003.pdfJune 7, 2011: HHS Announces $40 Million in ACA Funds for Chronic Disease Prevention Programs HHS announced the availability of approximately $40 million in grants, funded from the ACA Prevention and Public Health Fund, to strengthen and coordinate activities within state and territorial health departments aimed at preventing chronic diseases and promoting health. The application deadline is July 22, 2011. More details are available at: http://www.hhs.gov/news/press/2011pres/06/20110607a.html

June 6, 2011: CMS Issues Final Rule on Preventing Health Care Acquired Illnesses CMS published a final rule in the Federal Register on an ACA provision that will reduce or prohibit payments to doctors, hospitals, and other health care providers for services that result from certain preventable health care acquired illnesses or injuries. The new rule prohibits states from making payments to providers under the Medicaid program for conditions that are reasonably preventable. It uses Medicare’s list of preventable conditions in inpatient hospital settings as the base and provides states with the flexibility to identify additional preventable conditions and settings for which Medicaid payment will be denied. The final rule is effective July 1, 2011, but gives states the option to implement between its effective date and July 1, 2012. For more information, see: http://www.gpo.gov/fdsys/pkg/FR-2011-06-06/pdf/2011-13819.pdf

June 6, 2011: CMS Announces FQHC Advanced Primary Care Practice Demonstration CMS opened the application process for the Federally Qualified Health Center Advanced Primary Practice (FQHC APCP) demonstration project, a new ACA initiative to improve care coordination for Medicare patients. Applications will be accepted through August 12, 2011, and the demonstration will be conducted from September 1, 2011 through August 31, 2014. Click here for more information: http://www.hhs.gov/news/press/2011pres/06/20110606a.html

June 6, 2011: MedPAC Comments on Accountable Care Organization Proposed Rule The Medicare Payment Advisory Commission (MedPAC) provided comments to CMS on the Accountable Care Organizations proposed rule, published in the Federal Register on April 7, 2011. The comments can be accessed at: http://www.medpac.gov/documents/06062011_ACO_CMS1345_MedPAC_COMMENT.pdf

May 31, 2011: HHS Announces Changes to Pre-Existing Condition Insurance Plan (PCIP) HHS announced that PCIP premiums will be reduced and eligibility standards will be eased for the federally administered PCIP programs. In addition, HHS sent letters to those states that operate their own PCIP programs to inform them of the opportunity to modify their programs. Additional details can be found at: http://www.healthcare.gov/news/factsheets/pcip05312011a.html

May 23, 2011: HHS Implements Rate Increase Disclosure and Review HHS issued a final rule in the Federal Register to implement the Affordable Care Act (ACA) requirements for health insurance issuers regarding disclosure and review of unreasonable premium increases. Under the new program, all rate increases that meet or exceed a specified threshold must be reviewed by states or CMS. The final rule has several additions to the proposed rule, issued in December 2010, including a requirement that states provide a mechanism for public input. To view the rule, which is effective July 18, 2011, go to: http://www.gpo.gov/fdsys/pkg/FR-2011-05-23/pdf/2011-12631.pdf

May 20, 2011: CMS Requests Applications for Pioneer Accountable Care Organization (ACO) Model CMS published a notice in the Federal Register announcing a request for applications for organizations to participate in the Pioneer ACO Model for the 2011-2016 period. Letters of intent are due June 10, 2011. Click here for details: http://www.gpo.gov/fdsys/pkg/FR-2011-05-20/pdf/2011-12383.pdf

May 20, 2011: HRSA Publishes NPRM on ACA 340B Drug Pricing Provisions The Health Resources and Services Administration (HRSA) published a notice of proposed rulemaking (NPRM) in the Federal Register on the 340B program, which will be the first in a series of regulations that outline the program’s requirements. This proposal addresses the ACA provision that adds several new categories of eligibility for program participants, with certain exclusions for the drugs covered under the program. More information can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-05-20/pdf/2011-12423.pdf

May 17, 2011: HRSA Awards $4.9 Million for Family-to-Family Health Information Centers HRSA announced the award of FY 2011 competitive and non-competitive grants for Family-to-Family Health Centers, which ACA extended through FY 2012. For more information, including a listing of awards by state, see: http://www.hrsa.gov/about/news/pressreleases/110517familytofamily.htmlMay 17, 2011: CMS Announces Three New Accountable Care Organization (ACO) Initiatives CMS announced three initiatives to give new options and incentives to participate in ACOs: a funding opportunity for the Pioneer ACO Model, designed for advanced organizations ready to participate; request for comments on an Advance Payment ACO model that would provide additional up-front funding; and new accelerated development learning sessions for provider groups. Click here for additional details: http://tinyurl.com/6zlkgvm

May 16, 2011: CMS Seeks Comments on Medicare and Medicaid Alignment CMS is requesting comments on opportunities to more effectively align benefits and incentives to prevent cost-shifting and improve access to care for the dual eligible. Comments must be received by July 11, 2011. For more information, click here: http://www.gpo.gov/fdsys/pkg/FR-2011-05-16/pdf/2011-11848.pdf

May 13, 2011: HHS Announces $100 Million for Community Transformation Grants HHS announced the availability of more than $100 million in funding for up to 75 Community Transformation Grants, created by ACA and funded by the Prevention and Public Health Fund. Details on the funding announcement can be found at: http://www.hhs.gov/news/press/2011pres/05/20110513c.html

May 12, 2011: CMS Releases New Report on Medicare Savings CMS issued the following report that outlines savings resulting from improvements to the Medicare program, including implementation of many Affordable Care Act (ACA) provisions: http://www.cms.gov/apps/files/medicare-savings-report.pdf

May 11, 2011: CMS Announces New Process to Provide States with Medicare Data for Dual Eligibles The Medicare-Medicaid Coordination Office, within CMS, is making available a process for states that provides faster access to Medicare Parts A, B, and D data for dual eligibles to support care coordination and help states identify high-risk and high-cost individuals. More details can be found at: http://www.cms.gov/medicare-medicaid-coordination/Downloads/Coordinated-Care-Info-Bulletin.pdf

April 29, 2011: CMS Launches Hospital Value-Based Purchasing Program (HVBPP) CMS announced the development of the new HVBPP which will provide an estimated $850 million in FY 2013 to hospitals based on their overall performance in improving clinical processes of care and patient satisfaction. More information about the new program can be found here: http://www.hhs.gov/news/press/2011pres/04/20110429a.htmlApril 22, 2011: CMS Issues Guidance on National Correct Coding Initiative CMS released the following letter to states to clarify earlier guidance on the National Correct Coding Initiative and address state concerns regarding provider appeals: http://www.cms.gov/smdl/downloads/SMD11003.pdf

April 22, 2011: CMS Issues Third Funding Opportunity for National Background Check Program CMS issued a funding opportunity for the National Background Check Program, included in section 6201 of ACA, for those states and territories that did not submit proposals during the first two solicitations. States that applied during the first two solicitations but did notreceive the full award amount may apply for the remaining amount. For additional information, see: http://www.ffis.org/sites/ffis.org/files/public/National_Background_Check_Program.pdf

April 20, 2011: AOA Posts Webinar on Community-Based Care Transition Program (CCTP) The Administration on Aging (AOA) posted slides, transcript, and an audio recording of its webinar on CCTP, a new program that provides funding to test models for improving care transitions for high-risk Medicare beneficiaries. The information is available at (under AOA Webinar Series): http://www.aoa.gov/Aging_Statistics/Health_care_reform.aspx#mapApril 19, 2011: CMS Publishes Final Rule on Enhanced Matching Rate Medicaid Eligibility Systems CMS published a final rule in the Federal Register to allow a 90% federal match rate for states to improve their Medicaid eligibility systems, effective through December 31, 2015. The rule outlines the performance standards and conditions states must meet to receive the funds. More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-04-19/pdf/2011-9340.pdf

April 19, 2011: CDC Publishes Notice of Intent to Award ACA Funding CDC announced its intent to use funds from the Prevention and Public Health Fund for approved applications for a previous funding opportunity, Enhanced Surveillance for New Vaccine Preventable Disease. For more details, click here: http://www.gpo.gov/fdsys/pkg/FR-2011-04-19/pdf/2011-9417.pdfApril 15, 2011: CMS Announces New Funding Opportunity for Community-Based Care The Centers for Medicare & Medicaid Services (CMS) is seeking applications for the Medicare Community-based Care Transitions Program, which was authorized by section 3026 of the Affordable Care Act (ACA). Proposals will be accepted on a rolling basis. More details can be found at: http://www.gpo.gov/fdsys/pkg/FR-2011-04-15/pdf/2011-9126.pdf

April 15, 2011: CMS Releases Proposed Rule on Home and Community-Based Services (HCBS) Waivers CMS published the following proposed rule in the Federal Register to modify HCBS waivers, including providing states with the option to combine existing waivers, and respond to comments from the advance notice of proposed rulemaking: http://www.gpo.gov/fdsys/pkg/FR-2011-04-15/pdf/2011-9116.pdf

April 14, 2011: HHS Announces New Flexibility for Medicaid HHS announced new initiatives to make Medicaid more flexible and to help states implement innovative practices. Specifically, HHS announced that 15 states will receive up to $1 million each to develop coordinated care for dual eligibles. HHS also issued a proposed rule on home and community-based services, and the final regulation on developing and upgrading Medicaid IT enrollment systems. For more information, see: http://www.hhs.gov/news/press/2011pres/04/20110414a.htmlApril 12, 2011: HHS Announces New Partnership for Patients’ Initiative HHS announced a new initiative to improve care and lower health care costs. As part of the initiative, HHS announced it will provide $1 billion in funds from the ACA. Of that total, $500 million is for the Community-based Care Transitions program and $500 million for demonstrations related to reducing hospital-acquired conditions. More details can be found at: http://www.hhs.gov/news/press/2011pres/04/20110412a.htmlApril 6, 2011: FDA Proposes Rules for Food Labeling Provisions The Food and Drug Administration (FDA) published two proposals in the Federal Register to implement provisions of ACA related to nutrition labeling of menu items in restaurants and other similar establishments as well as labeling of food in vending machines. To view the notices, including a fact sheet and more information about submitting comments, see: http://www.fda.gov/Food/LabelingNutrition/ucm248732.htmApril 5, 2011: CMS Will Stop Accepting Applications for Early Retiree Reinsurance Program (ERRP) CMS published the following notice in the Federal Register to announce that it will stop accepting applications for ERRP, due to the lack of funds, as of May 5, 2011: http://www.gpo.gov/fdsys/pkg/FR-2011-04-05/pdf/2011-7934.pdf

April 4, 2011: CMS Releases Guidance on CHIP Coverage of Children of Public Employees CMS released initial guidance to states regarding the new option, included in the ACA that allows states to receive federal matching funds for coverage of children of state employees through the Children’s Health Insurance Program (CHIP). To view the guidance, go to: http://www.cms.gov/smdl/downloads/SHO11002.pdf March 31, 2011: CMS Unveils Proposed Rule on Accountable Care Organizations (ACO) CMS released a proposed rules to implement the Medicare Shared Savings Program created by ACA, which would provide incentives for physicians and hospitals to create ACOs. The proposal is expected to be published in the Federal Register on April 7, 2011, and comments are due by June 6, 2011. To view the proposal, click here: http://www.ofr.gov/(X(1)S(yaueomnnscb1nvko3qsllpnn))/OFRUpload/OFRData/2011-07880_PI.pdf

March 25, 2011: CMCS Provides Information on Implementation of CHIPRA and ACA The Center for Medicaid, CHIP and Survey & Certification (CMCS) released the following bulletin that provides additional details on CHIPRA performance bonuses; section 2301 of ACA, which ensures Medicaid coverage of care provided in freestanding birth centers; dental services in federally qualified health centers; the model interstation coordination process for Medicaid and CHIP; and Pediatric Quality Measures Program grants: http://www.cms.gov/CMCSBulletins/downloads/CMCS-Info-Bulletin-March-2011-Final.pdfMarch 25, 2011: CDC Announces New Funding Opportunity for Public Health Improvement Programs The Centers for Disease Control and Prevention (CDC) announced that it is providing an additional $34.2 million for public health improvement programs, funded through the Affordable Care Act (ACA) Prevention and Public Health Fund. Eligible applicants include the public health agencies that are current grant recipients of Strengthening Public Health Infrastructure for Improved Health Outcomes. To access the application, click here: http://www.cdc.gov/ostlts/NPHII/nphiifoa.html March 24, 2011: CDC Announces New Accreditation Opportunity for Health Departments CDC is supporting a national voluntary accreditation program for public health agencies. This new program complements efforts of the National Public Health Improvement Initiative. More details are available at: http://www.cdc.gov/media/releases/2011/p0324_publichealthdeptaccreditation.html?source=govdelivery

March 23, 2011: House Committee Releases Report on Exhaustion of Funding for Early Retiree Reinsurance Program A new analysis by the House Energy and Commerce Republican staff finds that the $5 billion Early Retiree Reinsurance Program will exhaust its resources prior to the planned sunset on January 1, 2014. The report is available at: http://energycommerce.house.gov/media/file/PDFs/032311_ERRP.pdf

March 22, 2011: CDC Announces FY 2011 Funding Opportunity for National Public Health Improvement Initiative CDC announced $34 million for a non-competitive supplement to strengthen public health infrastructure, funded through ACA Prevention and Public Health Fund. Applications are due May 2, 2011. For more information, see: http://www.cdc.gov/ostlts/NPHII/nphiifoa.html

March 21, 2011: HHS Announces National Strategy for Quality Improvement HHS released its National Strategy for Quality Improvement in Health Care, as required by ACA. The strategy creates national goals and priorities to guide local, state, and national efforts to improve the quality of health care. More details are available at: http://www.hhs.gov/news/press/2011pres/03/20110321a.htmlMarch 18, 2011: CMS Issues Final Rule for Nursing Home Civil Money Penalties CMS published the following rule in the Federal Register to revise and expand current Medicare and Medicaid regulations regarding the imposition and collection of civil money penalties by CMS when nursing homes are not in compliance with federal participation requirement in section 6111 of the Affordable Care Act (ACA): http://www.gpo.gov/fdsys/pkg/FR-2011-03-18/pdf/2011-6144.pdfMarch 14, 2011: HHS and Treasury Propose Process for State Innovation Waivers HHS and Treasury released a proposed rule that sets forth the framework for submission and review of initial applications for the state innovation waivers, included in section 1332 ACA. Comments are due by May 13, 2011. The proposed rule is available at: http://www.gpo.gov/fdsys/pkg/FR-2011-03-14/pdf/2011-5583.pdf

March 14, 2011: CMS Issues Rule on Graduate Medical Education Payments CMS published an interim final rule with comment period in the Federal Register to implement provisions included in the Medicare and Medicaid Extenders Act of 2010 (which modified ACA) related to full-time equivalent resident caps for graduate medical education payments. To view the notice, click here: http://www.gpo.gov/fdsys/pkg/FR-2011-03-14/pdf/2011-5960.pdf

March 11, 2011: ACF Releases Guidance on New Requirements for State TANF Funds ACF released the following program instruction to inform states of an ACA provision requiring state Temporary Assistance for Needy Families (TANF) plans to indicate whether the state intends to assist individuals in training for, seeking, and maintaining employment in the eldercare workforce: http://www.acf.hhs.gov/programs/ofa/policy/pi-ofa/2011/pi201106/pi201106.html

March 2011: HHS Releases Letter on the Impact of H.R. 1 on ACA HHS released a letter to the Senate Finance Committee on how Medicare and Medicaid would be affected if the House-passed version of H.R. 1 were enacted. H.R. 1 would prohibit the use of funds included in the CR for implementing or carrying out provisions of ACA. To view the letter, see:http://www.ffis.org/sites/ffis.org/files/public/HHS_Letter_HR1.pdfMarch 7, 2011: CMS Publishes Proposed Consumer Discloser Notices CMS proposed consumer disclosure notices, as required by ACA, that would require insurers to complete and report electronically when they propose rate increases over 10%. More details on the consumer disclosure notices can be found at: http://tinyurl.com/6yprrge

March 4, 2011: MEDPAC Releases Two Comment Letters to CMS The Medicare Payment Advisory Commission (MEDPAC) released two letters commenting on the proposed rule related to the Hospital Inpatient Value-Based Purchasing program as well as the request for proposals for the development of service delivery and payment model demonstration programs for beneficiaries who are dually eligible for Medicare and Medicaid. To view the letters, see: http://www.medpac.gov/

March 3, 2011 CRS Issues Memorandum on Medicaid MOE Provisions The Congressional Research Service (CRS) released a memorandum to the Senate Finance Committee regarding the authority of the secretary of HHS to waive the Medicaid maintenance of effort (MOE) provisions included in ACA. CRS finds that there is sufficient flexibility in the underlying Medicaid statute and the new health law for the secretary to grant MOE waivers under certain conditions. The memorandum is available at: http://www.ffis.org/sites/ffis.org/files/public/CRS_March_3_2011.pdfMarch 3, 2011: CMS Expands Advisory Panel on Outreach and Education CMS announced that it is renaming the Advisory Panel on Medicare Education to the Advisory Panel on Outreach and Education. With the enactment of health care reform, the panel will expand to include Medicaid and CHIP. More details are available at: http://www.gpo.gov/fdsys/pkg/FR-2011-03-03/pdf/2011-4754.pdf

4) March 2, 2011: HHS Releases Report on Early Retiree Reinsurance Program HHS issued the following report on implementation and operation of the early retiree reinsurance program during calendar year 2010, which includes approved applications and payments by state: http://www.ed.gov/news/press-releases/eight-states-receive-funding-turn-around-persistently-lowest-achieving-schoolsMarch 1, 2011: Joint Congressional Committee Report on Medicaid Expansion A new report, Medicaid Expansion in the New Health Law: Costs to the States, finds that the Medicaid expansion will cost states at least $118 billion through 2023. To view the report, which includes links to various state estimates released in the past year, click here: http://energycommerce.house.gov/media/file/PDFs/030111MedicaidReport.pdfFebruary 26, 2011 CMCS Highlights Recent Developments in Medicaid CMCS provided an overview of recently released rules, grants, and guidance, including the Community First Choice proposed rule, Money Follows the Person Grants, Medicaid Prevention Grants, and the maintenance of effort letter. Click here for more details: http://www.cms.gov/CMCSBulletins/downloads/2-28-11-Recent-Developments-In-Medicaid.pdfFebruary 24, 2011: Kaiser Family Foundation (KFF) Releases Report on State Budgets Under Health Reform KFF issued the following report that examines potential costs and savings that health care reform may generate for state budgets as well as explains why recent state estimates of the impact of health care reform vary widely: http://www.kff.org/healthreform/8149.cfmFebruary 23, 2011: AOA Updates Webinar Information on Care Transitions The Administration on Aging (AOA) updated slides, transcript, and audio recording related to its webinar series on participating in the community-based care transition program, section 3026 of ACA. The information is available at the following link, under Updates: http://www.aoa.gov/Aging_Statistics/Health_care_reform.aspx#map

February 25, 2011: CMS Provides Details on MOE Provisions CMS provided guidance on the maintenance of effort (MOE) provisions for Medicaid and CHIP in ACA. The guidance can be accessed at: http://www.cms.gov/smdl/downloads/SMD11001.pdf

February 24, 2011: HHS Announces Second Round of Premium Rate Review Grants HHS announced the availability of approximately $200 million in grants to help support states in developing health insurance premium rate review programs. For more details, click here: http://www.hhs.gov/news/press/2011pres/02/20110224a.html

February 23, 2011: CMS Releases Funding Announcement for Prevention of Chronic Diseases CMS is inviting proposals from states to compete for the Medicaid Incentives for Prevention of Chronic Diseases Program. Complete grant applications are due by May 2, 2011. The funding opportunity and guidance can be found at: http://www.cms.gov/MIPCD/February 22, 2011: HHS Announces Money Follows the Person (MFP) Awards ACA provided additional funding and extended the MFP demonstration program through FY 2016. HHS announced that 13 states would receive approximately $45 million in first-year awards. For more information, click here: http://www.hhs.gov/news/press/2011pres/02/20110222b.html

February 22, 2011: CMS Releases Proposed Rule on Community First Option CMS released a proposed rule to implement section 2401 of ACA that establishes a new state option to provide home and community-based attendant services and supports. To view the proposed rule, including instructions for providing comments, see: http://www.gpo.gov/fdsys/pkg/FR-2011-02-25/pdf/2011-3946.pdfFebruary 18, 2011: CMS Issues Interim Final Rule on Long-Term Care (LTC) Facilities CMS amended the requirements that a LTC facility must meet to qualify to participate as a skilled nursing facilities in the Medicare program or a nursing facility in the Medicaid programs. These requirements implement section 6113 of ACA. The interim final rule is available at: http://www.gpo.gov/fdsys/pkg/FR-2011-02-18/pdf/2011-3806.pdfFebruary 17, 2011: CMS Posts New Webpage for State Medicaid Recovery Audit Contractor (RAC) Programs CMS posted a new webpage that includes information about each state’s RAC program. In the future, CMS expects to expand the page to include performance data. The new webpage is located: www.cms.gov/medicaidracs/home.aspx

February 16, 2011: HHS Announces Early Innovator Grants HHS announced the award of seven cooperative agreements to help a group of states design and implement the information technology infrastructure needed to operate health insurance exchanges. For more information, including the list of awards, see: http://www.hhs.gov/news/press/2011pres/02/20110216a.htmlFebruary 11, 2011: CMS Publishes Proposed Rule on Student Health Insurance Coverage CMS released the following proposed regulation that would establish rules for student health insurance coverage under the Affordable Care Act (ACA) and the Public Health Service Act: http://www.gpo.gov/fdsys/pkg/FR-2011-02-11/pdf/2011-3109.pdfFebruary 10, 2011: HHS Announces New Resources for Pre-Existing Condition Insurance Plan (PCIP) HHS announced new resources that are available to raise awareness of PCIP, including a new website, a newsletter, and posters/brochures. For details, see: http://www.hhs.gov/news/press/2011pres/02/20110210a.htmlFebruary 10, 2011: HHS Posts State Data on PCIP HHS announced state-by-state enrollment in PCIP as of February 1, 2011. To view the data, go to: http://www.healthcare.gov/news/factsheets/pcip02102011a.html

February 9, 2011: HHS Announces FY 2011 Funds for Prevention and Public Health Fund ACA authorized and appropriated $750 million for the Prevention and Public Health Fund in FY 2011. HHS announced that the funds will be dedicated to community prevention ($298 million), clinical prevention ($182 million), public health infrastructure ($137 million), and research and tracking ($133 million). In addition, HHS posted a comparison of FY 2010 and FY 2011 prevention and public health funds at the program level as well as additional details by state regarding the FY 2010 funds. More information is available at: http://www.healthcare.gov/news/factsheets/prevention02092011b.htmlFebruary 8, 2011: HRSA Releases Updated Information on Maternal, Infant, and Early Childhood Home Visiting Program The Health Resources and Services Administration (HRSA) released supplemental information that provides guidance for preparing the updated state plan for the Affordable Care Act (ACA) Home Visiting Program. More details are available at: http://www.hrsa.gov/grants/manage/homevisiting/sir02082011.pdf

February 4, 2011: GAO Releases Report on Association Between Parent and Child Health Insurance Status GAO issued a report that examined the following: 1) the extent a parent’s health insurance status is associated with a child’s health insurance status, use of services, and parental satisfaction with their child’s care; and 2) how selected states’ parent coverage under Medicaid and CHIP may change given upcoming expansions included in ACA. To access the report, click here: http://www.gao.gov/products/GAO-11-264

February 2, 2011: CMS Issues Final Rule on Certain ACA Provision CMS published a final rule in the Federal Register to implement provisions of ACA that establish additional screening requirements, application fees, temporary enrollment moratoria, payment suspensions, and compliance plans for providers and suppliers in the Medicare, Medicaid, and CHIP programs. To view the rule, see: http://www.gpo.gov/fdsys/pkg/FR-2011-02-02/pdf/2011-1686.pdfFebruary 2, 2011: HHS Requests Comments on Planning and Establishment of Consumer Operated and Oriented Plan Program HHS issued the following announcement in the Federal Register that requests comments by March 4, 2011, on section 1322 of ACA, which requires the secretary to establish the consumer operated and oriented plan program: http://www.gpo.gov/fdsys/pkg/FR-2011-02-02/pdf/2011-2254.pdfDecember 2010: CMS Report Provides Details on Impact of ACA on Medicaid Expenditures The CMS Office of the Actuary released the 2010 Actuarial Report on the Financial Outlook for Medicaid. The report finds that ACA is expected to increase total Medicaid expenditures by $455 billion from FY 2010 through FY 2019, a $434 billion increase in federal expenditures and a $21 billion increase in state expenditures. Of the total amount, $428 billion is a result of the Medicaid expansion, and $26 billion is result of additional Medicaid administrative costs. The full report is available at: http://www.cms.gov/ActuarialStudies/downloads/MedicaidReport2010.pdf

February 1, 2011: Federal District Judge Rules Health Care Reform Law Unconstitutional Federal district judge Roger Vinson issued his ruling granting summary judgment to the state of Florida in its challenge to the constitutionality of ACA. The judge found that the law is unconstitutional because a person's refusal to buy health insurance does not amount to economic activity and is therefore beyond Congress's power to regulate under the Constitution's commerce clause. The judge, in his opinion, wrote that the entire law must be voided because the individual mandate provision is not severable from the rest of the law. In addition, he ruled that the challenge to the Medicaid expansion was without merit because states are free to leave the Medicaid program at will. The law's constitutionality is expected to ultimately be settled by the Supreme Court. To read Judge Vinson's opinion, go to: http://op.bna.com/hl.nsf/id/mapi-8dms88/$File/fla%20decision.pdfJanuary 28, 2011: HHS Releases Report on Health Insurance Premiums HHS released the following report on health care premiums under ACA: http://www.hhs.gov/news/press/2011pres/01/20110128a.html

January 26, 2011: CMS Publishes Notice on New Organization Structure CMS published a notice in the Federal Register that announces the establishment of the new Center for Consumer Information and Insurance Oversight (previously, the Office of Consumer Information and Insurance Oversight) as part of CMS: http://www.gpo.gov/fdsys/pkg/FR-2011-01-26/pdf/2011-1580.pdf

January 25, 2011: HRSA Announces Funding for New Teaching Health Centers The Health Resources and Services Administration (HRSA) announced the designation of 11 new Teaching Health Centers, a new program in ACA to support primary care residency training in community-based centers. For more information, including funding awards, click here: http://www.hrsa.gov/about/news/pressreleases/110125teachinghealthcenters.html

January 24, 2011: HHS and DOJ Release Report on Health Care Fraud, New Rules The departments of Health and Human Services (HHS) and Justice (DOJ) released their annual report on the Health Care Fraud and Abuse Control Program, which allowed the federal government to recover $4 billion in 2010. In addition, HHS announced a final rule on fraud prevention, authorized by ACA, that creates new provider screening and enrollment processes for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). More details can be found at: http://www.hhs.gov/news/press/2011pres/01/20110124a.html

January 21, 2011: HHS Releases Medicare Part D Coverage Gap Information by State HHS released the following data by state that shows the number of Medicare Part D recipients who have reached their Medicare drug plan’s coverage gap as of December 14, 2010, and will be mailed a rebate check through the end of January 2011: http://www.healthcare.gov/news/factsheets/donut_hole_checks_by_state.html

January 20, 2011: HHS Announces New Funding Opportunity for Health Insurance Exchanges HHS announced a new funding opportunity to help states implement health insurance exchanges. HHS is providing states with the option of applying for one-year funding or multi-year funding, depending on the state’s progress. In addition, states can use the funds for a variety of activities, such as conducting background research, consulting with stakeholders, making legislative and regulatory changes, and establishing information systems. For more information on the exchange establishment grants, see: http://www.hhs.gov/news/press/2011pres/01/20110120b.htmlJanuary 11, 2011: AOA Releases ACA News The Administration on Aging (AOA) released its monthly news on the Affordable Care Act (ACA) covering events from December 2010 to January 2011: http://www.aoa.gov/AoARoot/Aging_Statistics/docs/ACA_Enews_1210_0111.pdfJanuary 5, 2011: HHS Plans to Move OCIIO to CMS The secretary of HHS released the following letter that outlines plans to move the Office of Consumer Information and Insurance Oversight (OCIIO) to CMS: http://www.ffis.org/sites/ffis.org/files/public/Sebelius_LetterOCIIO.pdfJanuary 5, 2011: HHS Announces New Office for Administering CLASS Act To implement the provisions of the Community Living Assistance Service and Supports (CLASS) Act included in ACA, HHS announced that it is creating the Office of CLASS within AOA. More details are available at: http://www.ffis.org/sites/ffis.org/files/public/SebeliusLetterCLASSAct.pdfJanuary 7, 2011: CMS Proposes New Hospital Value-Based Purchasing Program CMS is seeking comments on a proposed rule to establish a new hospital value-based purchasing program. Under the program, value-based incentive payments would be made to hospitals that meet performance standards. The proposal can be found at: http://www.ofr.gov/OFRUpload/OFRData/2011-00454_PI.pdf

December 30, 2010: CMS Issues Guidance on ACA Medicaid Payment Provision CMS released guidance on a Medicaid payment provision in ACA, Section 6505, related to the prohibition on payments to institutions or entities located outside of the United States. The guidance, which is effective January 1, 2011, is available at: http://www.cms.gov/smdl/downloads/SMD10026.pdfDecember 27, 2010: CMS Develops RAC Program for Medicare Part C and D CMS is seeking comments on its proposed Recovery Audit Contractor (RAC) program for the Medicare Part C and D programs, an expansion required by ACA. Comments must be received by February 25, 2011. For more information, see: http://edocket.access.gpo.gov/2010/pdf/2010-32498.pdf

December 23, 2010: HHS Publishes Regulation on Premium Rate Review HHS published in the Federal Register a proposed rule that would implement a provision in ACA that establishes a rate review program to ensure all rate increases that meet or exceed an established threshold are reviewed by a state or HHS. Comments are due before February 22, 2011. The notice can be accessed at: http://edocket.access.gpo.gov/2010/pdf/2010-32143.pdf

December 22, 2010: Louisiana Receives FMAP Disaster-Recovery Adjustment ACA provides for an increase in the Federal Medical Assistance Percentage (FMAP) rate for qualifying states that have experienced a major statewide disaster. HHS issued the adjustments for the fourth quarter of FY 2011 and FY 2012. Louisiana was the only state to receive an adjustment. For more information, including a detailed description of the methodology, click here: http://edocket.access.gpo.gov/2010/pdf/2010-32054.pdf

December 22, 2010: CMS and ONC Announces Registration for Electronic Health Records (EHR) Incentives CMS and the national coordinator for Health Information Technology (ONC) announced the availability of registration for the Medicare and Medicaid EHR incentive programs. On January 3, 2011, registration will be available for eligible health care professionals and hospitals wishing to participate in the Medicare program. The Medicaid program is limited to select states at this time. More information can be found at: http://tinyurl.com/237ovlv

December 21, 2010: HHS Announces New Regulation on Premium Rate Review HHS announced a proposed rule that would implement a provision in ACA that directs HHS, in conjunction with states, to establish a process for the annual review of unreasonable increases in health insurance rates. Under the regulation, all proposed rate increases at or above 10% would be subject to review, and insurers would be required to provide a justification to states and HHS. In addition, states would conduct the reviews. However, if a state lacks the resources or authority to do thorough actuarial reviews, HHS would conduct them.

December 16, 2010: CMS Announces New Requirements for State Health Insurance Assistance Program (SCHIP) CMS announced new requirements for SCHIP grants to increase beneficiaries’ awareness about provisions included in ACA. These requirements are part of the FY 2011 grant announcement. Additional details can be found at: http://tinyurl.com/29unono

December 15, 2010: CMS Announces Demonstration to Integrate Care for Dual Eligible Individuals CMS released information on a new state demonstration project for dual eligible individuals, one of the first initiatives of the new Center for Medicare and Medicaid Innovation. CMS will award funds to up to 15 states. Proposals are due February 1, 2011. More information is available at: http://www.cms.gov/CMCSBulletins/downloads/12-10-2010-Federal-Coordinated-Health-Care-Office.pdf

December 15, 2010: GAO Releases Report on Medicaid Outpatient Prescription Drugs GAO released a report on Medicaid outpatient prescription drugs, which estimated the changes to federal upper limits using the formula under ACA. For more information, see: http://www.gao.gov/products/GAO-11-141R

December 14, 2010: OCIIO Releases Transcript of Technical Assistance Call on Early Innovators Grant Announcement OCIIO posted the transcript of the third pre-application conference call for the cooperative agreement to support innovative exchange IT systems. For more information, see the Health Insurance Exchange Information Technology Systems section of the following web page: http://www.hhs.gov/ociio/initiative/index.html

December 13, 2010: U.S. District Judge Finds the "Individual Mandate" Provision of the Affordable Care Act (ACA) Unconstitutional A federal district court in Virginia ruled that the requirement that individuals carry health insurance violates the Constitution. The court's ruling differs from earlier federal court rulings in Michigan and the Western District of Virginia that upheld the law. The court did not grant plaintiff’s request for a nationwide injunction against the law, ruling instead that implementation should continue on the other provisions. The differences between the courts are likely to lead to a series of appeals that will take the case to the U.S. Supreme Court.

December 10, 2010: ONC Seeks Comments on HIT Agenda and Implementation The Office of the National Coordinator for Health Information Technology (ONC) published a notice in the Federal Register requesting comments on a recent report on the nation’s health information technology (HIT) agenda and ONC’s implementation of the Health Information Technology for Economic and Clinical Health Act (HITECH Act). To access the notice, see: http://edocket.access.gpo.gov/2010/pdf/2010-31159.pdf

December 2, 2010: ACF Releases State Letter on Refugees and Health Care Reform The Administration for Children and Families (ACF) issued a letter to inform states of the latest information on health care reform as well as the health and mental health activities underway at the Office of Refugee Resettlement. To view the letter, click here: http://www.acf.hhs.gov/programs/orr/policy/sl11-01.htm

December 6, 2010: Quality Measures Workgroup Seeks Comment on Clinical Quality Measures The Quality Measures Workgroup, part of the Health Information Technology (HIT) policy committee, is requesting comment on concepts for meaningful use by December 23, 2010. For more information, see: http://tinyurl.com/2cbpxqvDecember 1, 2010: Urban Institute Releases Report on ACA and State BudgetsThe Urban Institute released the following report on the net effects of ACA on state budgets: http://www.firstfocus.net/sites/default/files/StateCost_Dorn_0.pdfDecember 1, 2010: HHS Publishes Medical Loss Ratio Requirements HHS published in the Federal Register the interim final regulation implementing the medical loss ratio requirements for health insurance issuers under the Affordable Care Act (ACA). The interim final regulation is effective January 1, 2011, and comments are due on January 31, 2011. More details are available at: http://edocket.access.gpo.gov/2010/pdf/2010-29596.pdf

November 2010: OCIIO Releases Transcript of Technical Assistance Calls on Early Innovators Grant Announcement The Office of Consumer Information and Insurance Oversight (OCIIO) posted the transcript of the first and second pre-application conference calls for the cooperative agreement to support innovative exchange IT systems. For more information, see the Health Insurance Exchange Information Technology Systems section of the following web page: http://www.hhs.gov/ociio/initiative/index.html

November 23, 2010: HHS Releases Guidance on ACA Changes Impacting AIDS Drug Assistance Programs (ADAPs) ACA changed which out-of-pocket expenses count toward the Medicare Part D annual out-of-pocket threshold. HHS issued the following letter to Ryan White HIV/AIDS program grantees that outlines how this change affects ADAP clients who are Medicare Part D enrollees: http://hab.hrsa.gov/law/ltr1011.pdfNovember 23, 2010: HHS and USDA Send Human Service Agencies Information on ACA HHS and USDA sent a joint letter to state human service agencies to provide recently released information on Medicaid and Health Insurance Exchanges. To view the letter, click here: http://www.ffis.org/sites/ffis.org/files/public/HHS_USDA_Human_Service_Letter.pdf

November 2010: AOA Announces New ACA eNews The Administration for Aging (AOA) announced an electronic newsletter that provides up to date information on ACA, including federal notices, state and local resources and activities, and upcoming events and trainings. The November 2010 edition is available at: http://www.aoa.gov/AoARoot/Aging_Statistics/docs/November292010.pdf

November 22, 2010: HHS Issues New Medical Loss Ratio Regulations HHS announced new medical loss ratio regulations that require health insurers to spend at least 80% of premium dollars on direct care and quality improvement activities. These regulations certify and adopt the recommendations submitted by the National Association of Insurance Commissioners (NAIC). More information is available at: http://www.hhs.gov/news/press/2010pres/11/20101122a.html

November 22, 2010: HHS Announces New Application Cycle for Loan Repayment Program HHS announced a new round of funding for the National Health Service Corps Loan Repayment Program, which includes $290 million in funds from ACA, to address shortages in the primary health care workforce. For more information, click here: http://www.hhs.gov/news/press/2010pres/11/20101122b.html

November 19, 2010: HRSA Awards $8 Million for Existing Community Health Centers HRSA awarded almost $8 million in ACA funds to help develop and modernize community health centers. These resources will provide additional training and technical assistance to community-based organizations that support health centers. To view the awards by state, see: http://www.hhs.gov/news/press/2010pres/11/20101119b.html

November 18, 2010 : HHS Provides Initial Guidance to States on Exchanges HHS issued initial guidance to states on health care exchanges, which covers the following areas: principles and priorities for the exchanges, an outline of the statutory requirements, clarifications and policy guidance related to exchange issues, and federal support for the establishment of state-based exchanges. The guidance is available at: http://www.healthcare.gov/center/regulations/guidance_to_states_on_exchanges.html

November 16, 2010: CMS Announces Center for Medicare and Medicaid Innovation, New Funding Opportunities ACA created the Center for Medicare and Medicaid Innovation to explore innovations in health care delivery and payment. As part of the launch of the Innovation Center, CMS announced new initiatives to strengthen primary care and better coordinate care for patients. Eight states have been selected to participate in the Multi-Payer Advanced Primary Care Practice Demonstration. States will also be eligible for an upcoming funding opportunity to support development of new models aimed at improving care quality, care coordination, and cost-effectiveness for those eligible for both Medicare and Medicaid (the dual eligibles). Two additional dual eligible health care integration demonstrations will be announced in 2011. For more details, see: http://www.innovations.cms.gov/innovations/pressreleases/pr110910.shtml

November 16, 2010: CMS Releases Guidance on Health Homes for Medicaid Enrollees CMS provided preliminary guidance on the implementation of a state option, included in ACA, that allows states to provide health homes for Medicaid enrollees with chronic conditions. The guidance is available at: http://www.cms.gov/smdl/downloads/SMD10024.pdf

November 16, 2010: CDC Seeks Comments on Development of Health Risk Assessment Guidance The Centers for Disease Control and Prevention (CDC) is seeking public comment on the development of guidance concerning a health risk assessment. ACA requires that the assessment be included in the annual wellness visit benefit authorized for Medicare beneficiaries. For more information, see: http://edocket.access.gpo.gov/2010/pdf/2010-28788.pdf

November 8, 2010: CMS Issues Proposed Rule on Federal Funding for Medicaid Eligibility Determination and Enrollment Activities CMS released a proposed rule in the Federal Register that proposes a 90% federal matching rate for design and development of new Medicaid eligibility systems and 75% for maintenance and operations. States must meet various performance standards and conditions to qualify for the enhanced match. The notice is available at: http://edocket.access.gpo.gov/2010/pdf/2010-27971.pdf

November 5, 2010: CMS Proposes New Rule to Reduce Improper Payments in Medicaid ACA requires states to establish Medicaid Recovery Audit Contractor (RAC) programs by submitting state plans to CMS by December 31, 2010. The proposed regulation outlines the requirements that states must meet and the federal contribution CMS will provide to assist in funding the state programs. To view the proposal, click here: http://www.ofr.gov/OFRUpload/OFRData/2010-28390_PI.pdf

November 3, 2010: CMS and OCIIO Release Joint Guidance on Exchange and Medicaid IT Systems CMS and the Office of Consumer Information and Insurance Oversight (OCIIO) released guidance to assist states to design, develop, implement, and operate technology and system projects related to establishment and operation of Health Insurance Exchanges as well as coverage expansions and improvements under Medicaid and CHIP. The full guidance is available at: http://www.hhs.gov/ociio/regulations/joint_cms_ociio_guidance.pdf

November 3, 2010: HHS, Treasury Announce Recipients of Biomedical Research Grants The departments of HHS and Treasury announced the recipients of the $1 billion in new therapeutic discovery project credits and grants included in ACA. For more information, including a listing of recipients by state, see: http://www.irs.gov/businesses/small/article/0,,id=228690,00.html

October 29, 2010: HHS Announces New Funding Opportunity for Health Insurance Exchanges HHS announced a new competitive funding opportunity for states to design and implement the Information Technology (IT) infrastructure needed to operate Health Insurance Exchanges. Applications are due December 22, 2010.

October 27, 2010: HHS Releases State-by-State Information on ACA Grant Funding HHS has added a new feature on HealthCare.gov that provides information on Affordable Care Act (ACA) grants awarded to each state. HHS notes that the grants do not represent total ACA funding for each state. To view this information, click on the following link and select your state: http://www.healthcare.gov/center/

October 26, 2010: HHS Announces Funding Opportunity for Family-to-Family Health Information Centers HHS announced $3.9 million in funding to continue support for Family-to-Family Health Information Centers. These centers are non-profit organizations run by families and for families with children with special health care needs. ACA extended funding for this program through FY 2012. For more information, go to: http://www.hhs.gov/news/press/2010pres/10/20101026f.html

October 26, 2010: HHS Announces Availability of $335 Million for Community Health Centers HHS announced a grant opportunity of $335 million for existing community health centers under the Expanded Services initiative, funded by the ACA. Grant applications are due January 7, 2011. For additional details, see: http://www.hhs.gov/news/press/2010pres/10/20101026a.html

October 19, 2010: HHS Announces Awards for Consumer Assistance Grants HHS awarded nearly $30 million to states and territories to support efforts to establish or strengthen consumer assistance programs. For more information on the new program, including grant awards by state, see: http://www.healthcare.gov/news/factsheets/capgrants_states.html

October 13, 2010: HHS Updates Q&A on Pre-Existing Condition Exclusion HHS updated its questions and answers on enrollment of children under 19 under the new policy that prohibits pre-existing condition exclusions. The document includes a letter from the secretary of HHS to the National Association of Insurance Commissioners (NAIC) regarding child-only policies: http://www.hhs.gov/ociio/regulations/children19/factsheet.html

October 9, 2010: SAMHSA Announces $71.5 Million in Mental Health Care Transformation Grants As part of its strategic initiative on health care reform, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced 20 new mental health transformation grants, totaling up to $71.5 million over five years. Program and award information can be found at: http://www.samhsa.gov/newsroom/advisories/1010081619.aspx

October 8, 2010: HHS Awards $727 Million to Community Health Centers HHS announced the award of $727 million to 143 community health centers to address construction and renovation needs and expand access to quality health care. The funds are the first in a series of awards that will be made available to community health centers under the ACA. For more information, and to view the awards by state, go to: http://www.hhs.gov/news/press/2010pres/10/20101008d.html

October 6, 2010: HHS Announces $13 Million in Grants under the National Background Check Program HHS awarded $13 million to six states to design comprehensive applicant criminal background check programs for jobs involving direct patient care. An additional 11 states applied for funds under the new program and may receive awards in the next two months. CMS also plans to issue a second solicitation later this month for those states that did not apply in round 1. Additional information is available at: http://www.hhs.gov/news/press/2010pres/10/20101006a.html

October 1, 2010: CMS Issues Guidance on Expansion of Recovery Audit Contractor (RAC) Program CMS issued preliminary guidance on Section 6411 of the Affordable Care Act (ACA), which requires states to establish programs to contract with RACs to audit payments to Medicaid providers by December 31, 2010. To view the guidance, click here: http://www.cms.gov/smdl/downloads/SMD10021.pdf

September 30, 2010: HHS Awards Evidence-Based Teen Pregnancy Prevention Grants, Abstinence Education HHS announced the award of $100 million for the Teen Pregnancy Prevention program, funded by the FY 2010 appropriations act, $55 million for the Personal Responsibility Education Program (PREP), funding by ACA, and $33 million for programs promoting abstinence, funded by ACA. More information, including grantees by state, can be found at: http://www.hhs.gov/news/press/2010pres/09/20100930a.html

September 30, 2010: HHS Awards Health Insurance Exchange Planning Grants HHS awarded $49 million to 48 states and the District of Columbia to assist with initial planning activities related to health insurance exchanges. More information, including a fact sheet and a list of grant awards, can be found at: http://www.hhs.gov/news/press/2010pres/09/20100930b.html

September 30, 2010: GAO Announces Appointments to National Health Care Workforce Commission The Government Accountability Office (GAO) announced the appointment of 15 members to the new National Health Care Workforce Commission. The commission, created by ACA, will serve as a resource for Congress, the president, and states and localities. For a listing of the commissioners and more information on the role of the commission, see: http://www.gao.gov/press/nhcwc_2010sep30.html

September 28, 2010: CMS Provides Further Guidance on Medicaid Prescription Drugs Provisions in ACA CMS issued guidance to states that revises the previous instructions concerning the federal offset of Medicaid prescription drug rebates and provides additional information on the offset rebate methodology, rebates for Medicaid Managed Care Organization (MCO) drugs, and other related items. The guidance is available at: http://www.cms.gov/smdl/downloads/SMD10019.pdf

September 28, 2010: HHS Announces $24 Million in Pregnancy Assistance Fund Grants HHS awarded $24 million in competitive grants to 17 states and tribes to support pregnant teens and women under the Pregnancy Assistance Fund, created by ACA. For a listing of grant awards, click here: http://www.hhs.gov/news/press/2010pres/09/20100928d.html

September 27, 2010: HHS Awards $320 Million to Expand Primary Care Workforce HHS announced $320 million in grants under ACA to strengthen the health care workforce. Of that total, $253 million is to expand the primary care workforce, and $67 million is for Health Profession Opportunity Grants for low-income individuals. Additional details on the grants, as well as awards by state, can be found at: http://www.hhs.gov/news/press/2010pres/09/20100927e.html

September 27, 2010: HHS Awards $68 Million to Support Community Living HHS announced $68 million in grants to states and other organizations to help seniors and individuals with disabilities navigate their health and long-term care options. The competitive and formula grants were included in ACA and focus on four main areas: Medicare outreach, counseling grants, nursing home transition through Money Follows the Person grants, and evidence-based care transition grants. To view the awards by state, go to: http://www.hhs.gov/news/press/2010pres/09/20100927a.html

September 24, 2010: HHS Awards $21.6 Million to Health Departments to Support HIV/AIDS Strategy HHS announced the award of $21.6 million in grants to state and local health departments to focus on HIV prevention. The funds were allocated from the Prevention and Public Health Fund included in ACA. For more information on the grants, see: http://www.hhs.gov/news/press/2010pres/09/20100924c.html

September 24, 2010: HHS Awards $26.2 Million to Expand Primary Care to Individuals with Behavioral Health Disorders HHS awarded grants to 43 community agencies to support and promote better primary care and behavioral health services for individuals with mental illnesses or substance abuse disorders. Most of the grants are funded by ACA’s Prevention and Public Health Fund. A listing of awardees can be found at: http://www.samhsa.gov/newsroom/advisories/1009245435.aspx

September 24, 2010: HHS Highlights $100 Million in Grants for Public Health and Prevention Priorities HHS issued a press release that provides details on $100 million awarded to date from the Prevention and Public Health Fund. These grants support state and community efforts to fight obesity, increase HIV testing, promote tobacco quit lines, expand mental health and substance abuse programs, and respond to disease outbreaks. Click here for more information: http://www.hhs.gov/news/press/2010pres/09/20100924a.html

September 23, 2010: HHS Seeks Comments on Action Plan to Prevent Healthcare-Associated Infections HHS is seeking comment on three new strategies of its action plan to prevent and reduce healthcare-associated infections. Comments are due on October 11, 2010. Additional details are available at: http://edocket.access.gpo.gov/2010/pdf/2010-23762.pdf

September 20, 2010: CMS Issues Proposed Rule on Fraud Prevention CMS released a proposed rule that includes new provider screening and enforcement measures to help prevent fraud and strengthen Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). In addition, the proposed rule contains new authority to suspend payments to providers based on credible allegations of fraud. To view the regulations, see http://www.ofr.gov/OFRUpload/OFRData/2010-23579_PI.pdf

September 20, 2010: CDC Announces $42.5 Million for Public Health Improvement Programs CDC has awarded $42.5 million in funding for 94 projects to state, local, tribal, and territorial health departments to improve their ability to provide public health services. The funding is part of the Prevention and Public Health Fund included in ACA. For more information and to view the awards, go to: http://www.hhs.gov/news/press/2010pres/09/20100920a.html

September 17, 2010: CMS Issues Proposed Rule on Medicaid Program Demonstrations CMS published a proposed rule to implement provisions in ACA that set forth transparency and public notice procedures for pilot and demonstration projects approved under section 1115 of the Social Security Act related to Medicaid and CHIP. Comments must be received by November 16, 2010. The proposed rule is available at: http://edocket.access.gpo.gov/2010/pdf/2010-23357.pdf

September 17, 2010: HHS Adopts Electronic Eligibility and Enrollment Recommendations HHS adopted recommendations on initial standards and protocols that facilitate electronic enrollment of individuals in federal and state health and human services programs. For more information, go to: http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3161

September 14, 2010: HHS Awards $31 Million for Prevention and Wellness Projects HHS announced $31 million for awards to states to support public health efforts to reduce obesity and smoking, increase physical activity, and improve nutrition. The awards are funded by the Prevention and Public Health Fund included in ACA. For more information, see: http://www.hhs.gov/news/press/2010pres/09/20100914a.html

September 13, 2010: CMS Issues Notice of Opportunity for National Background Check Program In early October, CMS plans to issue a second solicitation for the National Background Check Program for Patient Protection to allow states that did not apply the first time the opportunity to participate in the new grant program included in ACA. Additional details are available at: http://www.cms.gov/CMCSBulletins/downloads/09-13-2010-Criminal-Background-Checks.pdf

September 13, 2010: HHS Awards $16.8 Million to Train Public Health Workforce HHS announced the award of $16.8 million to 27 Public Health Training Centers (PHTC) at schools of public health and other public or non-profit institutions. Most of the funding for this existing program was made available by the Prevention and Public Health Fund included in ACA. To view the awards, see: http://www.hhs.gov/news/press/2010pres/09/20100913a.html

September 9, 2010: CMS Releases Guidance on Hospice Care for Children in Medicaid and CHIP CMS issued guidance on the provision in ACA that removed the prohibition of receiving curative treatment upon the election of the hospice benefit by or on behalf of a Medicaid or CHIP-eligible child. To view the guidance, see: http://www.cms.gov/smdl/downloads/SMD10018.pdf

September 8, 2010: CMS Reminds States of Opportunity to Comment on Home Health Changes in ACA CMS issues an information bulletin reminding states that comments on the proposed rule to implement the home health changes in ACA are due September 14, 2010. ACA requires that physicians document the existence of a face-to-face encounter with the Medicaid-eligible individual prior to ordering the provision of home health services. To view the bulletin, see: http://www.cms.gov/CMCSBulletins/downloads/09-08-2010-Home-Health.pdf

September 3, 2010: CMS Issues Proposal to Withdraw Portions of Medicaid Prescription Drug Rule CMS is proposing to withdraw the determination of average manufacturer price, multiple source drug definition, and upper limits for multiple source drugs. These changes are a result of lawsuit and provision included in ACA. To view the proposed changes, click here: http://edocket.access.gpo.gov/2010/pdf/2010-22115.pdf

September 1, 2010: CMS Issues Guidance on National Correct Coding Initiative (NCCI) CMS issued guidance on the ACA provisions related to the mandatory state use of the NCCI. The guidance is available at: http://www.cms.gov/smdl/downloads/SMD10017.pdf

August 30, 2010: HHS Seeks Additional Participants for Rural Community Hospital Demonstration HHS announced a solicitation for up to 20 additional eligible hospitals, which must be located in the 20 states with the lowest population density, to participate in the Rural Community Hospital Demonstration program. For more details, click here: http://edocket.access.gpo.gov/2010/pdf/2010-21512.pdfAugust 27, 2010: CMS Announces Listening Session on Medicare Data Sharing CMS announced a listening session on September 20, 2010, to obtain input on ACA provisions requiring that Medicare data be made available for performance measurement. For additional information, see: http://edocket.access.gpo.gov/2010/pdf/2010-21369.pdf

August 25, 2010: FDA Releases Guidance on ACA Provision The Food and Drug Administration released guidance on the effect of ACA on state and local menu and vending machine labeling laws. Additional information can be found at: http://edocket.access.gpo.gov/2010/pdf/2010-21067.pdf

August 24, 2010: ACF Posts Webinar for PREP and Abstinence Funding Opportunity ACF posted a recording and transcript of its August 19, 2010, webinar on the health care reform funding opportunity for the Personal Responsibility Education Program (PREP) and Abstinence Education funding: http://www.acf.hhs.gov/programs/fysb/content/news/prep_webinar.htm

August 19, 2010: CDC Announces Additional Funding for HIV Testing CDC published in the Federal Register a notice of intent to use funding from health care reform for awards to state and local public health departments for expanded HIV testing for disproportionately affected populations. More information can be found at: http://edocket.access.gpo.gov/2010/pdf/2010-20572.pdf

August 16, 2010: HHS Awards $46 Million for First Round of Health Insurance Premium Review Grants HHS announced that 45 states and the District of Columbia will receive $1 million each to help improve the oversight of proposed health insurance premium increases. More information, including a chart summarizing how each state will use the funds, can be found at: http://www.hhs.gov/news/press/2010pres/08/20100816a.html

August 12, 2010: CDC Announces Additional Funding for CPPW Program CDC published a notice in the Federal Register of its intent to use funds appropriated in the health care reform law to fund approved but unfunded applications under the Communities Putting Prevention to Work (CPPW) program. To view the announcement, see: http://edocket.access.gpo.gov/2010/pdf/2010-

August 9, 2010: HHS Announces Availability of Health Center New Access Point Grants HHS announced the availability of up to $250 million in New Access Point grants for the delivery of primary health care services for underserved and vulnerable populations under the Health Center Program. For more information, including a link to the funding announcement, see: http://www.hhs.gov/news/press/2010pres/08/20100809a.html

August 6, 2010: CMS Releases Guidance on Home- and Community-Based Services CMS released a State Medicaid Director Letter (SMDL) to provide information on the changes included the health care reform law, effective October 1, 2010, to improve access to home- and community-based services. Click here to see the letter: http://inside.ffis.org/ff/ImprovedAccesstoHCBS_SMD_letterFinal_8-6-10_1.pdf

August 5, 2010: HHS Awards $159 Million to Support Health Care Workforce Training HHS announced $159.1 million in grants to support three types of health care workforce training programs: Nursing Workforce Development programs; interdisciplinary geriatric education and training programs; and Centers of Excellence programs for under represented minority students. For more information and to view the awards by state, click here: http://www.hhs.gov/news/press/2010pres/08/20100805a.html

August 3, 2010: HHS Requests Comments on State-Level Exchanges The HHS Office of Consumer Information and Insurance Oversight released a notice in the Federal Register requesting comments on a series of questions related to planning and establishment of state-level exchanges. To view the notice, click here:http://edocket.access.gpo.gov/2010/pdf/2010-18924.pdf

July 26, 2010: CMS Announces $2.25 Billion to Extend "Money Follows the Person" Demonstration CMS released the funding opportunity for this demonstration program, which was extended by ACA. In addition, the secretary of HHS sent a letter to governors on the 20th anniversary of the Americans with Disabilities Act, which encourages states to continue to provide home- and community-based long-term care options. For greater details, click here: http://www.hhs.gov/news/press/2010pres/07/20100726a.html

July 22, 2010: AHRQ Releases Annual State Snapshots The Agency for Healthcare Research and Quality (AHRQ) released state-specific health care quality information for 2009, which is available at: http://statesnapshots.ahrq.gov/snaps09/index.jsp

July 21, 2010: HHS Allocates $88 Million for Home Visiting Program HHS announced $88 million in initial funding for Maternal, Infant, and Early Childhood Home Visiting Grants, authorized and funded under ACA. More information, including allocations by state, can be found at: http://www.hhs.gov/news/press/2010pres/07/20100721a.html

July 14, 2010: House Passes Technical Fixes to Medicaid and CHIP The House passed a bill (H.R. 5712) that makes technical fixes to Medicaid and the Children's Health Insurance Program (CHIP) by amending provisions included in the health care reform law and the Children's Health Insurance Program Reauthorization Act (CHIPRA). The Senate has not yet acted on similar legislation. The legislation is available at: http://thomas.loc.gov/cgi-bin/thomas

July 13, 2010: HHS Releases Guidance on Medicaid Provider Overpayments HHS released guidance on Section 6506 of ACA, which moves the deadline for states to recover Medicaid provider overpayments to one year from the date of discovery, after which adjustments must then be made to refund the federal portion of the overpayment. ACA did not change the requirement for states to refund the federal share of identified overpayments that are not recovered. The guidance can be found here: http://inside.ffis.org/ff/ACA_Overpayments_weeklynews_July20.pdfJuly 6, 2010: CMS Releases Guidance Letter Implementing Provisions of ACA The letter provides guidance on two Medicaid benefits related to provisions in ACA. Both provisions were effective as of March 23, 2010: 1) Section 2303 of ACA: State Eligibility Option for Family Planning Services establishes a new Medicaid eligibility group and the option for states to begin providing medical assistance for family planning services and supplies to individuals eligible under this new group. 2) Section 2001(c) of ACA: Medicaid Coverage for the Lowest Income Populations makes certain benefit changes that were enacted as part of ACA to benchmark plans. To letter can be seen here: http://inside.ffis.org/ff/FamilyPlanningandBenchmarkSHO_Final_7-2-10.pdf

July 2, 2010: HHS Announces Funding for Support of Pregnant and Parenting Teens and Women HHS's Office of Public Health and Science announced that it will begin accepting applications for the Pregnancy Assistance Fund, which was created by ACA. This $25 million competitive grant program will provide pregnant and parenting teens and women services to help them complete high school or post-secondary degrees and gain access to health care, child care, family housing, and other support. For more information, see: http://www.hhs.gov/ophs/oah/prevention/grants/announcements/index.htmlJuly 1, 2010: HHS Announces New Pre-Existing Condition Insurance Plan HHS announced the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured individuals unable to obtain health coverage because of a pre-existing health condition. The national PCIP is now open to applicants in the 21 states where HHS is operating the program. States that are operating their own programs will begin enrollment by the end of the summer, or sooner. More details can be found at: http://www.hhs.gov/news/press/2010pres/07/20100701a.html

July 1, 2010: HHS Launches Health Care Website As required by ACA, HHS released a new website, www.HealthCare.gov to provide consumers with public and private health care options.

June 30, 2010: HHS Releases FAQ Document on Home Visiting Grants HHS released the frequently asked question (FAQ) document on the first Funding Opportunity Announcement (FOA) for the Maternal, Infant, and Early Childhood Home Visiting Program. The FAQ can be found here: http://inside.ffis.org/ff/Home_Visiting_FAQ_1.pdf

June 29, 2010: HHS Releases Application for Early Retiree Reinsurance Program (ERRP)HHS published the program application and instructions for the ERRP program, established and funded under ACA. The application as well as more information on the program is available at: http://www.hhs.gov/ociio/regulations/index.html

June 25, 2010: HRSA Issues Changes to Loan Programs The Health Resources and Service Administration (HRSA) outlined the changes to the Nursing Student Loan program and the Primary Care Loan Program under ACA.

June 23, 2010: HHS Announces New Health Care Education and Training Grants for TANFHHS announced a new $51 million competitive grant program to provide training, education, and career advancement programs in health care professions for Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals. To view the funding application, see: http://www.acf.hhs.gov/grants/open/foa/view/HHS-2010-ACF-OFA-FX-0126

June 22, 2010: CMS Provides Information on Changes to MFP Demonstration CMS issued guidance on the five-year extension and modification to the Money Follows the Person Rebalancing (MFP) Demonstration Program included in the health care reform law, which is available at: http://www.cms.gov/smdl/downloads/SMD10012.pdf

June 21, 2010: CMS Informs States of New Process for Notification of Provider Terminations CMS issued an information bulletin that provides states with information on providers and suppliers that have been terminated from the Medicare program and CHIP. ACA required CMS to establish a notification process. The law also requires states to terminate any Medicaid provider that has been terminated for participation by Medicare or another state Medicaid program, effective January 1, 2011. In the near future, CMS will issue guidance on that provision. To view the bulletin, click here: http://inside.ffis.org//ff/cmcs06_20_10.pdf

June 18, 2010: CMS Discourages States from Collecting One-Time Medicare RebateCMS sent the following letter to all State Pharmaceutical Assistance Program Directors on the $250 rebate check for eligible Medicare Part D beneficiaries included in ACA: http://inside.ffis.org//ff/spap061810.pdf

June 18, 2010: HHS Announces Release of $500 Million from Prevention and Public Health Fund HHS announced the release of $500 million in FY 2010 funds from the Prevention and Public Health Fund included in the health care reform law. The funds will support the primary health care workforce as well as health and wellness initiatives. Additional details are included in the following two press releases and grant applications will be available at www.grants.gov:

June 10, 2010: CMS Releases Informational Bulletin on National Criminal Background Check Program CMS released a bulletin on the new national background check program. The bulletin, which includes information about an upcoming conference call for states considering participating in the program, can be found at: http://inside.ffis.org/ff/CMS_Information_Bulletin_6-10.pdf

June 10, 2010: NASADAD Releases Report on the Effects of Health Care Reform on Substance Abuse The National Association of State Alcohol and Drug Abuse Directors (NASADAD) released a report that examines the impact of state-level health reform on substance abuse systems in Maine, Massachusetts, and Vermont and provides considerations for implementation of the health care reform law. To view the report, see:http://www.nasadad.org/resource.php?base_id=2104

June 10, 2010: HRSA Announces $90 Million in New Maternal, Infant, and Childhood Home Visiting Program Grants HRSA announced availability of funding under the Maternal, Infant, and Early Childhood Home Visiting Program, a new program created under the health care reform law. For more information and to access the grant application, go to: http://www.hrsa.gov/about/news/pressreleases/100610.html

June 7, 2010: ACF Releases Guidance on Child Welfare Requirements in Health Care Reform ACF released guidance on a provision of the health care reform law designed to ensure that children receiving independent living services and/or education and training vouchers, and those who are aging out of foster care have information and education about having a health care power of attorney. For more information, go to:http://www.acf.hhs.gov/programs/cb/laws_policies/policy/pi/2010/pi1010.htm

June 7, 2010: HHS Announces $51 Million in Rate Review Grants HHS announced the availability of $51 million in Health Insurance Premium Review Grants through a new five-year $250 million grant program created and funded by the health care reform law. All states and the District of Columbia are eligible for this first round of rate review grants, and successful applications will receive a $1 million grant. For more information, go to:http://www.hhs.gov/news/press/2010pres/06/20100607a.html

June 4, 2010: ONC Announces New Enrollment Workgroup The Office of the National Coordinator for Health Information Technology (ONC) has organized a new enrollment workgroup to develop a set of standards that would facilitate enrollment in federal and state health and human services programs, including offerings by new health insurance exchanges. Additional details are available at:http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=2004&PageID=18539

June 3, 2010: HHS Announces $60 Million for Long-Term Care HHS announced the availability of $60 million in grants to states and communities to help individuals and their care givers better understand and navigate their health and long-term care options. For more details, click here: http://www.hhs.gov/news/press/2010pres/06/20100603b.html

June 2, 2010: HHS Announces the Multi-payer Advanced Primary Care Practice Demonstration HHS invited states to apply for participation in the Multi-payer Advanced Primary Care Practice Demonstration, a three-year initiative announced in September 2009 in which Medicare will join Medicaid and private insurers in state-based efforts to improve the delivery of primary care and lower health care costs. HHS anticipates making awards to up to six states. For more information, see: http://www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1230016

May 2010: Kaiser Report on Medicaid Coverage and Spending in Health Care Reform The Kaiser Commission on Medicaid and the Uninsured released a study that provides state-by-state estimates of the Medicaid expansion included in the health care reform law. To view the report, go to: http://www.kff.org/healthreform/8076.cfm

May 21, 2010: Treasury Issues Guidance on Therapeutic Discovery Project Program The Department of the Treasury announced the guidelines for applying for the new program created by the health care reform law, which will provide tax credits and grants for biomedical research. To view the guidance and fact sheet, go to:http://www.treasury.gov/press/releases/tg712.htm

May 17, 2010: IRS Issues Guidance on Small Business Health Credit The Internal Revenue Service (IRS) released guidance about the small-employer tax credit included in the health care reform law. The guidance clarifies that the federal credit will not be reduced because an employer is receiving a state health care subsidy. Additional information is available at: http://treasury.gov/press/releases/tg698.htm

May 13, 2010: HHS and DOJ Highlight Health Care Fraud and Abuse Efforts The departments of HHS and Justice (DOJ) announced new efforts to prevent fraud using tools provided by health care reform law. HHS also announced the creation of the Center for Program Integrity (CPI) at CMS. More information is available at: http://www.hhs.gov/news/press/2010pres/05/20100513a.html

May 11, 2010: CBO Releases Analysis of Potential Discretionary Costs of Health Care Reform The Congressional Budget Office (CBO) released an analysis on the potential effect of health care reform on discretionary spending. The full report is available at: http://www.cbo.gov/doc.cfm?index=11490

May 10, 2010: Federal Departments Issue Rule on Dependent Health Coverage The departments of HHS, Treasury, and Labor released an interim final rule that addresses provisions of health care reform that require plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26. To view the regulation and fact sheet, see: http://www.hhs.gov/ociio/regulations/index.html#dependent_coverage

May 5, 2010: HHS Releases Interim Final Regulations on Early Retirees Reinsurance ProgramThe health care reform law appropriated $5 billion for the Early Retiree Reinsurance Program and required that HHS establish it within 90 days after enactment. Both self-funded and insured plans can apply, including plans sponsored by state and local governments. To view the interim final rule and fact sheet, go to: http://www.hhs.gov/ociio/regulations/index.html#early_retiree

May 5, 2010: HHS Publishes Health Care Reform Web Portal Requirements HHS published an interim final rule regarding the health insurance web portal required by the health care reform law. The web portal is intended to assist individuals and small businesses in identifying health insurance coverage options in each state, effective July 1, 2010. The interim final rule adopts the categories of information that will be collected and displayed via the website, and the data required from issuers and requested from states, associations, and high-risk pools in order to create this content. For more information, including the interim final rule, go to: http://www.hhs.gov/ociio/regulations/index.html#health_care_reformMay 5, 2010: HHS Issues Letter to Governors on Health Insurance Rate ReviewsThe secretary of HHS sent a letter to governors asking them to review their rate authority under state law to determine if governors have the regulatory tools needed to approve health insurance rates before they take effect. In addition, the letter indicates that HHS intends to issue guidance on the $250 million included in the health care reform law to assist states in health insurance rate reviews. For more information, see: http://www.hhs.gov/news/press/2010pres/05/20100505a.html

May 2010: Integrated Health Care Act Available The House Legislative Counsel has published an integrated version of the Patient Protection and Affordability Act of 2010 (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152). To view the act, go to: http://www.ffis.org/health_care_reform

April 30, 2010: HHS Issues Update on High-Risk Pool Programs The health care reform law created a high-risk pool program to help adults who are uninsured and have a pre-existing condition access insurance. HHS has released a list of states that would like to run a high-risk pool program and those that would prefer that HHS administer the program. To view the information, see: http://www.healthreform.gov/forums/blog/blog_20100430_1.html

April 30, 2010: CMS Issues Rule on Medicaid Benefit Packages CMS published in the Federal Register a final rule regarding state flexibility for Medicaid benefit packages that was approved as part of the Deficit Reduction Act (DRA) of 2005 (P.L. 109-171). The final rule defines "benchmark" and "benchmark-equivalent" benefit packages. Additionally, the rule includes modifications required by CHIPRA (P.L. 111-3). CMS indicated there is a forthcoming regulation that will codify the benefits changes approved as part of the health care reform law. To view the rule, go to: http://edocket.access.gpo.gov/2010/pdf/2010-9734.pdfApril 2010: Moody's Releases Report on Health Care Reform Moody's Investor Services released a report titled, "Healthcare Reform Expected to Create Longer Term Financial Pressure for States." The report is here: http://inside.ffis.org//ff/Healthcare_Reform_Expected_to_Create_LongerTerm_Finan_Pressure_for_States.pdf

April 28, 2010: CRS Releases Report on Health Care Reform The Congressional Research Service (CRS) released a report on the Medicaid and CHIP provisions in health care reform. The report can be found here.

April 27, 2010: IRS Issues Guidance on New Dependent Health Coverage Policy IRS released guidance for provisions in the health care reform law that make health coverage provided for an employee's children under 27 years of age generally tax-free to the employee. The policy is effective retroactive to March 30, 2010. The IRS Notice 2010-38 is available at: http://www.irs.gov/pub/irs-drop/n-10-38.pdf

April 22, 2010: CMS Releases Guidance on Medicaid Prescription Drug Rebates CMS released the second in a series of letters that provide guidance on the health care reform legislation. This letter contains information on the increase in prescription drug rebate percentages and the extension of rebates for drugs dispensed to individuals enrolled in Medicaid managed care organizations (MCOs). It also outlines the savings that will be remitted to the federal government. To view the guidance, see: http://www.cms.gov/smdl/downloads/SMD10006.pdfApril 22, 2010: HHS Releases Fact Sheet on Temporary High-Risk Pool Program HHS released a fact sheet about the temporary high-risk pool program included in health care reform and a chart outlining potential allocations of high-risk pool funds to states. For more information, go to: http://www.hhs.gov/ociio/initiative/hi_risk_pool_facts.htmlApril 2010: UnitedHealth Releases Report on Health Care Reform and Modernization UnitedHealth released a report that provides state-specific estimates of the Medicaid expansion included in health care reform. It also includes potential state savings from Medicaid modernization. To view the report, see: http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper3.pdfApril 13, 2010: CRS Releases Report on Health Care Reform Law CRS released a report that identifies regulatory provisions and deadlines in the new health care reform law. The report is can be viewed here:http://inside.ffis.org/ff/CRS_Report_Regulations_Patient-Protection.pdf

April 12, 2010: HHS Releases Information on Medical Loss Ratio and Premium IncreasesIn an effort to implement health insurance reform law, HHS released information on medical loss ratios and premium increases. Specifically, HHS released a letter to the National Association of Insurance Commissioners (NAIC) requesting their assistance in defining medical loss ratio. The letter is available at:http://www.healthreform.gov/newsroom/naicletter.html

April 9, 2010: CMS Releases Guidance on Medicaid Expansion included in Health Care Reform Law CMS released the first letter in a series of guidance regarding the Medicaid changes that are included in the health care reform law. Specifically, this letter provides initial guidance on the new Medicaid state plan option to cover low-income childless adults. The letter is available at: http://www.cms.gov/smdl/downloads/SMD10005.PDF